Nadira Mamuon, Sajid Mushtaq, Naeem Raza Hamdani, Tahir Khadim, Tariq Sarfraz, Muhammad Amin Wiqar.
Hepatic histopathology in clinically suspected non-alcoholic fatty liver disease.
Pak J Pathol Jan ;19(1):20-4.

Introduction: Non-alcoholic fatty liver disease (NAFLD) includes a spectrum, ranging from steatosis to steatohepatitis (NASH). Liver biopsy remains the gold standard for the diagnosis. Objective: To study the spectrum of NAFLD in liver biopsies in clinically suspected cases of NASH. Methods: Forty cases with negative serology for Hepatitis B & C and suspected of primary NASH, who underwent liver biopsies were included in the study. Main findings looked for were steatosis, ballooning, lobular inflammation and perisinusoidal fibrosis predominantly in the zone 3 (perivenular) region. Scoring system (NAS) for grade and stage according to Kleiner et al was followed. Study design: Observational, cross sectional. Setting: Department of histopathology, Armed Forces Institute of Pathology, Rawalpindi. Results: A total of 40 cases were included with 12(30%) females and 28(70%) males and age range was 12-58 years. Twenty-seven cases (67.5%) fulfilled the histological criteria for NASH. 11(27.5%) were reported as NAFLD and 2(5%), which did not show any steatosis, were reported as chronic hepatitis. Conclusion: NASH must be kept in mind and excluded, when examining a liver biopsy, showing steatosis as it has a bearing on the further management strategy for the patient. A diagnosis of NAFLD should include complete histological details along with grading and staging according to the recommended scoring systems.

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