What will be the histological findings most likely to be seen in liver biopsy of a 20 year old male who died because of overdose of acetaminophen?
Acetaminophen causes centrizonal necrosis Zonal necrosis of liver There are three types of zonal necrosis : Centrizonal necrosis : It is characteristic of ischemic injury, acetaminophen toxicity, carbon tetrachloride exposure, or chloroform toxicity. Drugs such as acetaminophen may be metabolized in zone 1 to toxic compounds that cause necrosis of zone 3 hepatocytes because they receive the blood from zone 1. Midzonal necrosis - quite rare, but may be seen in yellow fever. Peripoal necrosis - is seen in phosphorus poisoning or eclampsia. Submassive necrosis refers to liver cell necrosis that crosses the normal lobular boundaries. Focal scattered necrosis : Characteristic of viral hepatitis It can also be seen with bacterial infections or other toxic insults. There is necrosis of small clusters of hepatocytes, that is located in some of the liver lobules. Steatohepatitis-like pattern of injury is caused by drugs like Methotrexate (immunosuppressive) Amiodarone (antiarrhythmic) Tamoxifen (anti-estrogen) Irinotecan (antineoplastic)
Focal scattered necrosis
Midzonal necrosis
Centrizonal necrosis
Steatohepatitis
Miscellaneous