82-year-old female exhibited a slightly enlarged liver. She had suffered from chronic cardiac insufficiency for a long time (specimen from autopsy).
- Centrilobular sinusoids and central veins are dilated and partially filled with blood.
- Atrophy of centrilobular hepatocytes is observed. The latter display some microvesicular steatosis and focal minimal necrosis. The observed changes affect predominantly zone 3.
- The centrilobular Disse spaces are clearly visible due to edema.
- The central vein exhibits minimal fibrosis only. Minimal deposits of collagen are also present in centrilobular sinusoids.
Over time, progressive fibrosis may develop affecting the entire lobule. Severe fibrosis in the setting of cardiac disease is sometimes called cardiac sclerosis or cirrhosis. Macroscopy: firm nutmeg liver.