Pathology of nonalcoholic fatty liver disease

Authors D.G. Tiniakos, Ch. Kittas.


Nonalcoholic fatty liver disease (NAFLD) may be the most
common cause of chronic liver disease in Western countries,
with an estimated prevalence of up to 24% in the general
population. NAFLD is considered the hepatic manifestation
of the metabolic syndrome and has been etiologically
correlated with insulin resistance. The histopathological
spectrum of NAFLD ranges from simple steatosis to
nonalcoholic steatohepatitis (NASH), with or without fibrosis,
and cirrhosis. Liver biopsy is the gold standard
for diagnosing NASH in a patient with clinical features of
NAFLD, image detected steatosis and chronically elevated
liver enzymes. This review discusses the histopathological
findings of NAFLD in adults and children, including features
representing resolution of NASH following treatment
and features of prognostic information. Additionally, current
systems of semiquantitative assessment in NAFLD and
NASH are reviewed and the concurrence of NAFLD and
NASH with other chronic liver diseases, mainly hepatitis
C, is discussed.
Key words: steatosis, steatohepatitis, nonalcoholic, liver,