SPECTRUM OF HEPATIC STEATOSIS AT AUTOPSY

Dr. Prajakta A. Gupte, Dr. Amita S. Joshi Seth

Abstract


Objectives: Steatosis is one of the most common histologic findings in the liver at any age and it may or may not be associated with alcohol
consumption. We undertook this study to assess:
1. Prevalence of fatty change, significant or otherwise, in liver, at autopsy
2. Risk factors/ causative factors/ associated lesions, if any
3. Severity of fibrosis with steatosis
4. Any associated iron deposition with fatty change
Methods: All liver sections from clinical autopsies (n=308) performed in the year 2011 were screened for fatty change. The cases with fatty change
were selected for further analysis. Special stains for collagen (Masson Trichrome) and iron (Prussian blue reaction) were performed on the liver
sections showing significant steatosis (> 10%). Fibrosis was graded as pericellular fibrosis (Stage 1), portal fibrosis (Stage 2), bridging fibrosis
(Stage 3) and cirrhosis (Stage 4). Clinical and autopsy case records were retrieved for analysis of risk factors, demographic and clinical data.
Results: Approximately 45% of cases showed steatosis of which around 30% showed significant steatosis. Common etiologies found were
alcoholism, obesity, tuberculosis, pregnancy, cardiac disorders and diabetes. Significant steatosis was also noted in the pediatric age group where
cardiac disorders were the commonest cause. Fibrosis and iron deposition were variable.
Conclusion: Prevalence of significant hepatic steatosis in this study was 30.5%. Among adults, alcoholism was the commonest risk factor. Others
were obesity, poor nourishment and diabetes. Among children, cardiac disorders were the commonest risk factor.


Keywords


Autopsy, hepatic steatosis, hepatic fibrosis, iron.

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