Alcoholic Steatohepatitis

Alcoholic steatohepatitis comprises macrovesicular steatosis, hepatocellular damage, inflammation, and fibrosis. The hepatocellular damage (as seen here) manifests with hepatocyte ballooning, cytoplasmic clearing, and intracytoplasmic Mallory-Denk bodies (Mallory’s hyaline). The swollen hepatocytes have reduced or absent cytokeratin 8/18 filaments, as demonstrated by CK8/18 immunostains; this feature is notably absent in non-steatohepatitic ballooning degeneration, such as that seen in viral hepatitis. The portal inflammatory infiltrate contains neutrophils and lymphocytes, which are predominantly CD4+ or CD8+ T-cells.