A Histological Study of Liver in Patients Diagnosed as Fatty Liver on Ultrasound

Abstract

Objectives: To confirm sonographic findings of fatty liver by histologic study of liver biopsies and to look for related histological changes associated with fatty liver.Material and method: It was case series study. The study was conducted in Gastroenterology unit of Hayatabad Medical Complex, Histology lab of Khyber Medical College Peshawar. The study period was five months. Ten cases labeled as fatty liver on Ultrasonography were designated for liver biopsy proceeded by microscopic study. The patients with advanced liver disease were excluded. Tissue slides were observed under light microscope. The morphometric measurements were carried out. Histological Scoring System for non-alcoholic fatty liver diseases was applied for histological staging and grading. Results: Microscopic examination showed that the mean value of size of hepatocytes and nuclei were significantly more than normal mean. 50% of total cases were with panacinar steatosis, zone 1 and zone 3 steatosis were noted in 20% and 30% of patients respectively. Ballooning was revealed in all the cases, while lobular inflammation was seen in 60% of patients. All of the cases depict various phases of fibrosis, but Cirrhosis could not be noticed in any of the specimen. 30% of the cases were recorded with definite non-alcoholic steatotic hepatitis (NASH), 50% were labelled as borderline NASH and 20% were as simple steatosis. Conclusions: All cases detected as simple fatty liver on ultrasonography are found with some degree of steatosis and steatohepatitis on histological examination. Morphometric study showed that steatotic process increases hepatocytes and nuclei size. Ballooning and lobar inflammation were the hallmark of NASH