Liver Necrosis

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Causes

  • severe metabolic disturbances [as seen in degenerative pathology link?]
  • toxic substances [link?]
  • nutritional deficiencies
  • action of micro-organisms

Histological patterns

  • Liver cell necrosis has been classified on an anatomic basis with reference to the distribution of the lesion
Random foci (focal)
  • microscopic foci of necrosis not related to any particular part of the liver lobule
  • can be due to a variety of insults
    • systemic viral, bacterial,and parasitic infections
    • result of bacteria being absorbed from the gut
  • examples
    • Equine herpes virus infection
      • in aborted foetuses
    • Salmonellosis
      • in calves
    • Toxoplasmosis (miliary)
      • in dogs and cats
Zonal necrosis
  • necrosis occurring mainly in a part of the lobule and further subdivided according to whether the lesions are situated centrally, peripherally, or in the mid-zone of the lobule
  • due to anoxia
Periacinar (centrilobular)
  • most common
  • main reason is because the hepatocytes in this zone are furthest away from the incoming blood supply
    • therefore less oxygenated and relatively anoxic
  • reported to contain the greatest number of enzymes responsible for metabolising sunstances to more toxic metabolites capable of killing the hepatocytes
  • hypoxic states and toxic substances predominate in this type of necrosis
  • some viral conditions cause this necrosis
    • eg Infectious Canine Hepatitis
  • poisons
    • eg carbon tetrachloride
Midzonal
  • rare
  • in pigs with alfatoxicosis
  • 'Yellow Fever' in man
Periportal (centroacinar)
  • rare
  • eg phosphorous poisoning


Massive necrosis
  • necrosis of large areas of liver cells comprising many lobules (complete acinus or several acini) and sometimes involving almost the whole organ
  • some cases of ICH infection or carbon tetrachloride poisoning, the severity of the injury replacing the zonal pattern
Subacute cytolytic necrosis
  • a condition in the dog
  • aetiology is entirely unknown
  • Clinical
    • acute abdominal pain
    • collapse
    • invariably jaundice
  • Gross
    • Liver is normal or reduced in size
  • Microscopically
    • severe necrosis
Hepatosis dietica
  • similar condition to subacute cytolytic necrosis
  • occurs in rapidly growing pigs
  • related to diet
    • fed on large quantities of grain concentrates
    • poor quality or low quantity protein supplements
  • Cause
    • nutritional deficiencies of selenium and Vitamin E, and probably amino acids
    • triggering mechanism is environmental stress

Test yourself with the Liver Pathology Flashcards

Liver Pathology Flashcards