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Alcoholic steatohepatitis comprises 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. Hepatocytes may also contain megamitochondria, which are 2-10um elongated or rounded intracytoplasmic eosinophilic bodies. Megamitochondria have a more definite outline than Mallory-Denk bodies and stain red with chromotrope-aniline blue (CAB), which stains Mallory-Denk bodies blue.

Image 14 of 34