Alcoholic hyaline

Alcoholic hepatitis also leads to a postsinusoidal block following the deposition of alcoholic hyaline in the centrilobular zone, with perivenous fibrosis and subsequent occlusion of the small veins. 

Central venules only contain a small amount of collagen, with the result that in this form of fibrosis, perivenous sinusoids are always involved as well. A typical example is perivenular fibrosis in chronic alcohol abuse, (s. fig. 21.16) Centrolobular fibrosis may also be detectable in healed viral hepatitis or following slight liver damage (e.g. Meulengracht s disease). Central hyaline sclerosis, which is due to chronic alcohol abuse with intermittently recurring alcohol hepatitis, is known to be a particularly severe form of fibrosis, (s. p. 526)... 

Liver cell hydrops Liver cell hydrops is characterized by swollen hepatocytes, which contain a lot of liquid, but are generally free of fat. Hydropic liver cells may be 2 to 4 and even 10 times the size of normal hepatocytes. Cell hydrops is completely reversible when abstention is maintained. These cells usually die when alcohol intake is continued and are subsequently removed by macrophages and leucocytes. This leads to an alteration in the cytoskele-ton. Hydropically degenerated liver cells and hyaline liberated from Mallory bodies produce a leucocytic inflammatory reaction. Unless it is compensated by regenerative processes, this cellular deficit results in defective healing by fine-fibred, cell-poor fibrils. 

Fig. 28.9 Alcoholic steatohepatitis. Satellitosis of neutrophilic granulocytes surrounding hydropic-degenerated hepatocytes with Mallory hyalin (—>)...

Fig. 31.7 Non-alcoholic steatohepatitis (NASH) Hydropic degenerated hepatocytes with Mallory s hyaline (- ) l)mphocytic and granulocytic infiltration as well as activated Kupffer cells (HE)...

First described in alcoholic patients by Frank B. Mallory in 1911, Mallory hyalines/bodies also appear in other chronic liver diseases.Sometimes they can be difficult to distinguish on biopsies, and ancillary immunohistochemistry with keratins CK18, 34 3E12, and CAM5.2, as well as antibodies to ubiquitin (Fig. 15.26), may help by highlighting them. They are also occasionally positive for CK7 and... 

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