78-year-old male suffered from chronic right heart failure with venous congestion due to chronic obstructive lung disease (specimen from autopsy).
- Centrilobular parenchymal atrophy
- Extensive centrilobular bridging fibrosis
- Numerous pigment laden macrophages as a consequence of old centrilobular hemorrhagic necrosis due to an episode of acute liver hypoperfusion
- Prominent bile ductular proliferations
- Presence of macro- and microvesicular steatosis in the viable periportal tissue.
Histologic features of both chronic passive hepatic congestion and centrilobular necrosis frequently occur together. Chronic passive hepatic congestion and centrilobular necrosis form a morphological continuum reflecting degrees of preexisting hepatic congestion and acute liver hypoperfusion leading to necrosis. The liver's gross appearance results from the contrast of red-brown centrilobular regions suffused with blood against viable, if somewhat fatty, periportal tissue.