50 year old male presents with chronic right heart failure. The succumbs to his illness. On autopsy, liver shows following changes:
Ans. (a) Nutmeg liverPathologically, the term nutmeg liver refers to the speckled appearance of the cut liver in chronic venous congestion, due to dilated and congested red central veins surrounded by paler, unaffected liver tissue (resembling a grated nutmeg kernel)Note the dark red congested regions that represent accumulation of RBC's in centrilobular regionsMicroscopically, the nutmeg pattern results from congestion around the central veinsNutmeg liver is most frequently seen in right heart failure QIf the passive congestion is pronounced, then there can be centrilobular necrosisIf chronic hepatic passive congestion continues for a long time, a condition called "cardiac cirrhosis" Q
Nutmeg liver
Normal liver
Hemosiderosis liver
Liver failure
Hemodynamics