Histopathology of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis

Table 1 Histopathological abnormalities in nonalcoholic steatohepatitis[7]

Histopathological abnormalities
Necessary components
Steatosis (macro > micro; accentuated in zone 3)
Lobular inflammation (mixed, mild; scattered polymorphonuclear leukocytes as well as mononuclear cells)
Hepatocellular ballooning (most apparent near steatotic liver cells, typically in zone 3)
Usually present; but not necessary for diagnosis
Perisinusoidal fibrosis (in zone 3)
Hepatocellular glycogenated nuclei (in zone 1)
Lipogranulomas (in the lobules; of varying size, but usually small)
Acidophil bodies or periodic acid-Schiff-stained Kupffer cells
Fat cysts
May be present but not necessary for diagnosis
Mallory-Denk bodies (in ballooned hepatocytes)
Iron deposition (in hepatocytes or sinusoidal lining cells)
Megamitochondria (in hepatocytes)