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Int. J. Mol. Sci. 2016, 17(1), 97; doi:10.3390/ijms17010097

Nonalcoholic Fatty Liver Disease: Pros and Cons of Histologic Systems of Evaluation

Department of Pathology and Immunology, Washington University School of Medicine, Campus Box 8118, St. Louis, MO 63110, USA
Academic Editors: Amedeo Lonardo and Giovanni Targher
Received: 15 December 2015 / Revised: 6 January 2016 / Accepted: 7 January 2016 / Published: 13 January 2016
(This article belongs to the Special Issue Non-Alcoholic Fatty Liver Disease Research 2016)
View Full-Text   |   Download PDF [182 KB, uploaded 13 January 2016]

Abstract

The diagnostic phenotype of nonalcoholic fatty liver disease (NAFLD)—in particular, the most significant form in terms of prognosis, nonalcoholic steatohepatitis (NASH)—continues to rely on liver tissue evaluation, in spite of remarkable advances in non-invasive algorithms developed from serum-based tests and imaging-based or sonographically-based tests for fibrosis or liver stiffness. The most common tissue evaluation remains percutaneous liver biopsy; considerations given to the needle size and the location of the biopsy have the potential to yield the most representative tissue for evaluation. The pathologist’s efforts are directed to not only global diagnosis, but also assessment of severity of injury. Just as in other forms of chronic liver disease, these assessments can be divided into necroinflammatory activity, and fibrosis with parenchymal remodeling, in order to separately analyze potentially reversible (grade) and non-reversible (stage) lesions. These concepts formed the bases for current methods of evaluating the lesions that collectively comprise the phenotypic spectra of NAFLD. Four extant methods have specific applications; there are pros and cons to each, and this forms the basis of the review. View Full-Text
Keywords: nonalcoholic fatty liver disease; nonalcoholic steatohepatitis; pathology nonalcoholic fatty liver disease; nonalcoholic steatohepatitis; pathology
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Brunt, E.M. Nonalcoholic Fatty Liver Disease: Pros and Cons of Histologic Systems of Evaluation. Int. J. Mol. Sci. 2016, 17, 97.

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