CORRELATION BETWEEN INTRASINUSOIDAL NEUTROPHILIC INFILTRATION AND CEROID-LIPOFUSCINOSIS IN ALCOHOLIC LIVER FIBROSIS WITH OR WITHOUT FATTY CHANGE - CLINICOPATHOLOGICAL COMPARISON WITH NUTRITIONAL FATTY LIVER

A histopathological study was conducted on alcoholic liver fibrosis wi th fatty change (21 cases) and alcoholic liver fibrosis without fatty change (18 cases) in comparison with nutritional fatty liver (27 cases ). The diagnoses of alcoholic liver fibrosis groups were clinically fu lfilled according to the criteria established by the Alcohol and Liver Research Group (Chief: Professor Takeuchi) of the Ministry of Educati on of Japan. Histological diagnosis of alcoholic liver fibrosis with f atty change was based on moderate and/or greater fatty metamorphosis o f the hepatic lobules, alcoholic liver fibrosis without fatty change o n a lesser degree of fatty metamorphosis than alcoholic liver fibrosis with fatty change, and nutritional fatty liver on clinicopathological features. All 66 cases were negative for viral markers of hepatitis B surface antigen and anti-hepatitis C virus in serum. Intrasinusoidal neutrophil infiltrations were significant in cases of alcoholic liver fibrosis groups more often than in cases of nutritional fatty liver. T he degree of intrasinusoidal neutrophil infiltration in cases of alcoh olic liver fibrosis groups was higher in cases who had last consumed a lcohol recently, compared with those with longer abstinence. In alcoho lic liver fibrosis with fatty change and nutritional fatty liver group s, mild-to-moderate degrees of ceroid-lipofuscinosis were recognized, but both fatty change and ceroid-lipofuscinosis were decreased accordi ng to the deterioration of fibrotic changes in alcoholic liver fibrosi s with fatty change cases. On the other hand, it is significant that t he frequency of ceroid-lipofuscinosis in alcoholic liver fibrosis with out the fatty change group was lower than those of the alcoholic liver fibrosis with fatty change and nutritional fatty liver groups. Distri bution of ceroid-lipofuscinosis has a tendency to be recognized around the central zone (zone III) of alcoholic liver fibrosis with fatty ch ange cases with mild fibrosis, as in nutritional fatty liver cases, an d the ceroid-lipofuscinosis disperses with the progression of fibrosis . These results suggest that fibrosis and fatty droplet deposition lea d to microvascular heterogeneity. Therefore, the degree and distributi on of fatty droplets, ceroid-lipofuscinosis, and intrasinusoidal neutr ophil infiltration differ, depending on the etiology of fatty liver, a nd are an important histopathological barometer in cases of alcoholic liver fibrosis with fatty change and alcoholic liver fibrosis without fatty change, thus indicating the degree of fibrosis and the period si nce last alcohol intake.