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Centrilobular necrosis
Other names	Central lobular necrosis, CN
Histopathology of shock liver (intermediate magnification), showing centrilobular necrosis but viable periportal hepatocytes.

Centrilobular necrosis (CN) is a nonspecific histopathological observation brought on by hepatotoxins like acetaminophen (paracetamol), thioacetamide, tetrachloride, cardiac hepatopathy due to acute right sided cardiac failure, and congestive hepatic injury in veno-occlusive disease, or hypoxic injury due to ischemia. Centrilobular necrosis can also be found in those with autoimmune hepatitis. Centrilobular necrosis is characterized by necrotic hepatocytes completely encircling the central vein.

Outlook

After a single or brief exposure to a toxicant, hepatocytes that have suffered centrilobular necrosis typically heal quickly; the liver can regain its normal appearance under a microscope in about a week. Nevertheless, fibrosis, which may be slight, occurs in the previously necrotic zone surrounding the central vein when regeneration replaces the necrotic hepatocytes if sinusoidal cells and the normal scaffolding are destroyed.

See also

• Hepatotoxicity
• Ischemic hepatitis

References

1. Gardner, C (October 15, 2003). "Exaggerated hepatotoxicity of acetaminophen in mice lacking tumor necrosis factor receptor-1 Potential role of inflammatory mediators". Toxicology and Applied Pharmacology. 192 (2). Elsevier BV: 119–130. doi:10.1016/s0041-008x(03)00273-4. ISSN 0041-008X. PMID 14550746.
2. ^ Alison, M R; Sarraf, C E (May 1, 1994). "Liver cell death: patterns and mechanisms". Gut. 35 (5). BMJ: 577–581. doi:10.1136/gut.35.5.577. ISSN 0017-5749. PMC 1374735. PMID 8200545.
3. Myers, R (2003). "Cardiac hepatopathy: Clinical, hemodynamic, and histologic characteristics and correlations". Hepatology. 37 (2). Ovid Technologies (Wolters Kluwer Health): 393–400. doi:10.1053/jhep.2003.50062. ISSN 0270-9139. PMID 12540790.
4. Hofer, H (March 1, 2006). "Centrilobular necrosis in autoimmune hepatitis: a histological feature associated with acute clinical presentation". Journal of Clinical Pathology. 59 (3). BMJ: 246–249. doi:10.1136/jcp.2005.029348. ISSN 0021-9746. PMC 1860344. PMID 16505273.
5. ^ Haschek, Wanda (23 November 2009). Fundamentals of Toxicologic Pathology. Academic Press. p. 208. ISBN 9780080919324.

Further reading

• Krishna, Murli (2017). "Patterns of necrosis in liver disease". Clinical Liver Disease. 10 (2). Ovid Technologies (Wolters Kluwer Health): 53–56. doi:10.1002/cld.653. ISSN 2046-2484. PMC 6467231. PMID 30992760.
• Misdraji, Joseph; Thiim, Michael; Graeme-Cook, Fiona M (2004). "Autoimmune Hepatitis With Centrilobular Necrosis". The American Journal of Surgical Pathology. 28 (4). Ovid Technologies (Wolters Kluwer Health): 471–478. doi:10.1097/00000478-200404000-00006. ISSN 0147-5185. S2CID 20808570.

External links

• WebPath
• Forms of hepatic injury at Pathology Outlines.

• Necrosis