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Alcoholic Steatohepatitis

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The main pathologic features of alcoholic steatohepatitis include macrovesicular steatosis, hepatocellular damage, inflammation, and pericellular fibrosis. The hepatocellular damage manifests with hepatocyte ballooning, cytoplasmic clearing, and intracytoplasmic Mallory-Denk bodies (Mallory’s hyaline), as seen here, which consist of dense eosinophilic intracytoplasmic material and may be highlighted by p62, ubiquitin, or CK8/CK18 immunostains. Pericellular (“chicken-wire”) fibrosis is characteristic: strands of collagen surround damaged hepatocytes, forming a network that is highlighted by Trichrome stains.

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