Liver cell necrosis

All forms of injury to liver such as microbiological, toxic, circulatory or traumatic, all results in the liver cell necrosis.

Types of Liver cell necrosis

 

Diffuse (Submassive to Massive)necrosis

When there is extensive or diffuse necrosis of the liver involving all the cells in groups of lobules, it is termed diffuse. It is most commonly caused by viral hepatitis or drug toxicity

Zonal necrosis

Necrosis of hepatocytes in three different zones of hepatic lobule.

Centrilobular necrosis

In hepatocytes of zone 3(located around central vein). It is characteristic feature of ischaemic injury such as in shock or CHF

Midzonal necrosis

Involves zone 2 of hepatic lobule. This pattern of necrosis is seen in yellow fever and viral hepatitis.

Periportal (peripheral) necrosis

Seen in zone 1 involving the parenchyma closest to the arterial and portal blood supply. Since zone 1 is most well perfused it is more vulnerable to circulating hepatotoxins e.g. in phosphorus poisoning and eclampsia.

Focal necrosis

It  involves small group of hepatocytes irregularly distributed in the hepatic lobule.most often caused by microbiological infections such as viral hepatitis, military tuberculosis, typhoid fever and other bacterial, viral and fungal infections

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