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Total parenteral nutrition (TPN) may induce hepatocellular injury resulting in macrovesicular steatosis, in which the hepatocyte nuclei are displaced by one or more fat vacuoles, or microvesicular steatosis, in which fat droplets are finely distributed in the hepatocyte cytoplasm. Steatohepatitis, consisting of steatosis with admixed inflammatory cells, and cholestasis (with inspissated bile) are seen here.