Liver, Alcoholic steatohepatitis

Steatohepatitis is characterized by the combination of hepatocyte injury, inflammation, steatosis and fibrosis. Required histological findings include the presence of macrovesicular steatosis (large droplets of fat within hepatocytes that push the nuclei to the periphery) with evidence of hepatocyte damage (hepatocyte ballooning, lobular inflammation with neutrophil predominance, Mallory-Denk bodies, megamitochondria, and fibrosis (most often pericellular and sinusoidal).

Note that alcoholic steatohepatitis is indistinguishable histologically from nonalcoholic steatohepatitis (NASH). Clinical history is required to definitively distinguish between these two entities.