Centrilobular necrosis

Centrilobular necrosis
Other namesCentral lobular necrosis, CN
Histopathology of shock liver (intermediate magnification), showing centrilobular necrosis but viable periportal hepatocytes.

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]

Outlook

After 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

References

  1. ^ 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.
  2. ^ 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.
  3. ^ 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.
  4. ^ 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.
  5. ^ a b Haschek, Wanda (23 November 2009). Fundamentals of Toxicologic Pathology. Academic Press. p. 208. ISBN 9780080919324.

Further reading