On Stopping Alcohol, all the following changes are reversible EXCEPT
Alcoholic steatofibrosis. Alcoholic hepatitis is often accom- panied by prominent activation of sinusoidal stellate cells and poal fibroblasts, giving rise to fibrosis. Fibrosis begins with sclerosis of central veins. Perisinusoidal scar then accumulates in the space of Disse of the centrilobular region, spreading outward, encircling individual or small clusters of hepatocytes in a chicken wire fence pattern (Fig. 18-19). These webs of scar eventually link to poal tracts and then begin to condense into central-poal fibrous septa. With developing nodularity, cirrhosis becomes established. When alcohol use continues without interruption over the long term, the continual subdivision of established nodules by new webs of, perisinusoidal scarring leads to a classic micronodular or Laennec cirrhosis first described for end-stage alcoholic liver disease (Fig. 18-21). Early stages of scarring can regress with cessation of alcohol use, but the faher along toward cirrhosis the liver gets, the more vascular derangements prevent a full restoration of normal. Complete regression of alcoholic cirrhosis,
Hepatitis
Cirrhosis
Microvesicular fatty change
Macrovesicular fatty change
G.I.T