Centrilobular necrosis (CN) is a nonspecific histopathological observation brought on by hepatotoxins like acetaminophen (paracetamol),[1] thioacetamide, tetrachloride,[2] cardiac hepatopathy due to acute right sided cardiac failure, and congestive hepatic injury in veno-occlusive disease,[3] or hypoxic injury due to ischemia.[2] Centrilobular necrosis can also be found in those with autoimmune hepatitis.[4] Centrilobular necrosis is characterized by necrotic hepatocytes completely encircling the central vein.[5]
| Centrilobular necrosis | |
|---|---|
| Other names | Central lobular necrosis, CN |
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| Histopathology of shock liver (intermediate magnification), showing centrilobular necrosis but viable periportal hepatocytes. | |
Outlook
editAfter a single or brief exposure to a toxicant, hepatocytes that have suffered centrilobular necrosis typically heal quickly; the liver can regain its normal appearance under a microscope in about a week. Nevertheless, fibrosis, which may be slight, occurs in the previously necrotic zone surrounding the central vein when regeneration replaces the necrotic hepatocytes if sinusoidal cells and the normal scaffolding are destroyed.[5]
See also
editReferences
edit- ^ Gardner, C (October 15, 2003). "Exaggerated hepatotoxicity of acetaminophen in mice lacking tumor necrosis factor receptor-1 Potential role of inflammatory mediators". Toxicology and Applied Pharmacology. 192 (2). Elsevier BV: 119–130. doi:10.1016/s0041-008x(03)00273-4. ISSN 0041-008X. PMID 14550746.
- ^ a b Alison, M R; Sarraf, C E (May 1, 1994). "Liver cell death: patterns and mechanisms". Gut. 35 (5). BMJ: 577–581. doi:10.1136/gut.35.5.577. ISSN 0017-5749. PMC 1374735. PMID 8200545.
- ^ Myers, R (2003). "Cardiac hepatopathy: Clinical, hemodynamic, and histologic characteristics and correlations". Hepatology. 37 (2). Ovid Technologies (Wolters Kluwer Health): 393–400. doi:10.1053/jhep.2003.50062. ISSN 0270-9139. PMID 12540790.
- ^ Hofer, H (March 1, 2006). "Centrilobular necrosis in autoimmune hepatitis: a histological feature associated with acute clinical presentation". Journal of Clinical Pathology. 59 (3). BMJ: 246–249. doi:10.1136/jcp.2005.029348. ISSN 0021-9746. PMC 1860344. PMID 16505273.
- ^ a b Haschek, Wanda (23 November 2009). Fundamentals of Toxicologic Pathology. Academic Press. p. 208. ISBN 9780080919324.
Further reading
edit- Krishna, Murli (2017). "Patterns of necrosis in liver disease". Clinical Liver Disease. 10 (2). Ovid Technologies (Wolters Kluwer Health): 53–56. doi:10.1002/cld.653. ISSN 2046-2484. PMC 6467231. PMID 30992760.
- Misdraji, Joseph; Thiim, Michael; Graeme-Cook, Fiona M (2004). "Autoimmune Hepatitis With Centrilobular Necrosis". The American Journal of Surgical Pathology. 28 (4). Ovid Technologies (Wolters Kluwer Health): 471–478. doi:10.1097/00000478-200404000-00006. ISSN 0147-5185. S2CID 20808570.