Department of Pathology and Immunology, Washington University School of Medicine, 660 S. Euclid Ave., Campus Box 8118, St. Louis, MO 63110, United States.
World J Gastroenterol. 2010 Nov 14;16(42):5286-96. doi: 10.3748/wjg.v16.i42.5286.
Histological analysis of liver biopsies remains a standard against which other methods of assessment for the presence and amount of hepatic injury due to nonalcoholic fatty liver disease (NAFLD) are measured. Histological evaluation remains the sole method of distinguishing steatosis from advanced forms of NAFLD, i.e. nonalcoholic steatohepatitis (NASH) and fibrosis. Included in the lesions of NAFLD are steatosis, lobular and portal inflammation, hepatocyte injury in the forms of ballooning and apoptosis, and fibrosis. However, patterns of these lesions are as distinguishing as the lesions themselves. Liver injury in adults and children due to NAFLD may have different histological patterns. In this review, the rationale for liver biopsy, as well as the histopathological lesions, the microscopically observable patterns of injury, and the differential diagnoses of NAFLD and NASH are discussed.
肝活检的组织学分析仍然是评估非酒精性脂肪性肝病 (NAFLD) 引起的肝损伤存在和程度的其他方法的标准。组织学评估仍然是区分脂肪变性与非酒精性脂肪性肝炎 (NASH) 和纤维化等 NAFLD 高级形式的唯一方法。NAFLD 的病变包括脂肪变性、肝小叶和门脉炎症、气球样变和凋亡形式的肝细胞损伤以及纤维化。然而，这些病变的模式与病变本身一样具有鉴别意义。由于 NAFLD，成人和儿童的肝损伤可能具有不同的组织学模式。在这篇综述中，讨论了肝活检的基本原理，以及组织病理学病变、可观察到的损伤显微镜模式以及 NAFLD 和 NASH 的鉴别诊断。
