Massive acute necrosis of liver
- The normal structure of the liver is unclear, which leads to difficulties in organ diagnosis.
- Only parts of portal spaces are preserved, at some spaces only blood vessels. Bile ducts show cholestasis.
- The rest of parenchyma is transected by extensive ‘bridging’ necroses (centro-central, centro-portal and porto- portal).
- Necrotic hepatocytes are replaced by a proliferation of Kupffer cells or inflammatory cells – lymphocytes, macrophages, neutrophil leukocytes.
- Cellular debris are impregnated with bile.
- Only at the periphery are left single undamaged hepatocytes or small groups of regenerated hepatocytes.
- A ’favorable’ (with regard to patients’ life) outcome would be to develop necrotic liver cirrhosis .