Alcoholism Mallory bodies

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. 

Alcoholic foamy degeneration is considered to be a variant of alcoholic fatty liver (T. Uchida et al., 1983). There is evidence of microvesicular steatosis, giant mitochondria, focal cell necrosis (with elevation of GPT, GOT and GDH) and cholestasis (with increase of AP and sometimes of bilirubin), whereas inflammatory alterations are rare and Mallory bodies totally absent. Likewise, there is no sign of fever or leucocytosis. (133)... 

Laparoscopic liver biopsy 2 wk later revealed progressive changes with a predominantly mononuclear infiltrate, and further collapse of the reticular framework. Mallory bodies were not seen on either biopsy, ruling out alcoholic hepatitis. The diagnosis was drug-induced cholestatic hepatitis. A steroid taper was initiated, with almost complete resolution on biopsy 1 mo later. The steroid was continued for 7 more weeks, with normalization of symptoms and laboratory tests (Alderman et al., 1994). 

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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