Differential Diagnosis of Hepatic Necrosis Encountered at Autopsy

Abstract

The liver is subject to a variety of extrinsic and intrinsic insults that manifest with both specific and nonspecific patterns of necrosis. In the autopsy setting, these patterns are often encountered as incidental findings or even causes of death. There are several etiologies of hepatic necrosis, including toxins, drug injuries, viral infections, ischemic injuries, and metabolic disease, all of which possess overlapping gross and histologic presentations. Nonetheless, patterned necrosis in the context of clinical and demographic history allows for the forensic pathologist to develop a differential diagnosis, which may then be pruned into a specific or likely cause. The aim of the following review is to elucidate these patterns in the context of the liver diseases from which they arise with the goal developing a differential diagnosis and ultimate determination of etiology.

PK/PD Modeling of the PDE7 Inhibitor—GRMS-55 in a Mouse Model of Autoimmune Hepatitis

“…In addition, necrosis of hepatocytes was observed in ConA-treated mice [12]. Similarly, both necrosis and Fas-mediated apoptosis of hepatocytes were reported in human AIH [16,17]. Previous studies on ConA-induced hepatitis models carried out by other research groups focused on assessing the dose-response relationship rather than the concentration-effect relationship of investigated compounds [18][19][20].…”

Nivolumab‐induced liver injury with a steroid‐refractory increase in biliary enzymes, in a patient with malignant mesothelioma: An autopsy case report

“…They have been described in previous reports of hepatic irAE, but each is difficult to distinguish from nonspecific lesions. Such randomly distributed lesions are usually not encountered in the autopsied liver 17 …”

“…Such randomly distributed lesions are usually not encountered in the autopsied liver. 17 Therefore, the heterogeneity of lesion distribution is considered to be the most characteristic pathological finding of NIVO‐induced hepatic irAEs.…”

Hepatoprotective Effect of Costus Afer On Trace Metal Mixture Treated Rats Mediated By Regulation of Oxidative Stress Markers, Inflammatory Cytokines And Bio-Metal Chelation

“…This relationship between these trace metals could as a result of the similarity of their oxidative states which makes them exhibit similar chemical properties.Certain histological changes, such as hepatocyte necrosis and in ammation and severe dysplasia of hepatocytes, were observed in the rats that received trace metal mixture in comparison to to the rats that received only deionized water. Hepatic necrosis, in ammation and cytoplasmic swelling are common symptoms of liver damage(Butler et al 2018). The protective effect of the Costus afer was observed in the rats co-treated with ALECA at doses of 750, 1500, and 2250 mg/kg.…”