There are five characteristics that can be seen:
- Some hepatocytes are swollen with very pale cytoplasm. This is called ballooning degeneration
- Some hepatocytes have no nuclei. This indicates necrosis
- Some hepatocytes have bright eosinophilic inclusion bodies called Mallory bodies
- Fibrosis is visible
- Neutrophils are present
Diagnosis: Alcoholic hepatitis
- Chronic (years of) alcohol consumption
These five histological findings are the five histological criteria that must be fulfilled to say that it is an alcoholic hepatitis.
This patient would probably also have an AST/ALT ratio of above 2:1, and possibly macrocytic anaemia as well.
All the characteristics are visible around the big portal triad, so I’d suggest you start looking there.
7. HBs antigen positivism (Shikata orcein)
9. Hepatocellular carcinoma in cirrhosis