These are just a few nice examples of focal hepatocellular necrosis in a decedent with a history of hepatitis C and intravenous drug use.
As always, free for use in lectures and teaching, etc. with or without attribution, though attribution is always appreciated. These are slightly reduced resolution images. If you need original resolution images, contact me.
Update: One correspondent suggested that this may be better considered something like lobular inflammation in nonspecific reactive hepatitis. That’s a good criticism. My response was:
‘Sure. Without the history, that’s what this guy would have had — though I usually just say “hepatitis” and move on. Focal hepatocellular necrosis is one of the components of it. One old article that comes up on a search states:
“Nonspecific reactive hepatitis represents a group of abnormal histological findings including ductular proliferation, portal and periportal inflammatory infiltration, focal necrosis, Kupffer cell mobilization, and evidence of regeneration…”
Schaffner F, Popper H. Nonspecific reactive hepatitis in aged and infirm people. Am J Digestive Dis. 1959 4:389-399.
A couple of sources (for instance, Sanjay Kakar in the book “Liver Pathology” 2011 Demos Medical Publishing) says you can, but don’t necessarily see focal necrosis in nonspecific reactive hepatitis. Instead, he focuses on “lobular inflammation.” My impression, which could easily be wrong, is that if you don’t see dead liver cells, it’s “lobular inflammation,” and if you do see dead liver cells, it’s “focal hepatocellular necrosis.” I thought I saw some dead hepatocytes in them thar hills, so I ran with the latter.’
Thank you for sharing this case~