Alcoholic Steatohepatitis
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Alcoholic steatohepatitis comprises macrovesicular steatosis with associated inflammation and fibrosis. In early stages, steatosis is most evident in perivenular areas (acinar zone 3), as seen here. Alcoholic steatosis is characteristically macrovesicular: large intracellular lipid droplets result in peripheral displacement of the hepatocyte nuclei. With disease progression, hepatocellular damage (ballooning, Mallory-Denk bodies), inflammation (neutrophils and lymphocytes), and pericellular fibrosis occur.