Normal lipid metabolism
Free fatty acids from adipose tissue or ingested food
Transported to hepatocytes
Cholesterol or phospholipids
STEATOSIS OR FATTY CHANGE
• Abnormal accumulation of triglycerides in liver
Toxin and Malnutrition
Accumulation of lipids
Fatty change or steatosis
FATTY CHANGE - LIVER
• Liver enlarges, become increasingly yellow, soft and greasy.
• Small vacuoles in cytoplasm around the nucleus
• Vacuoles coalesce displacing the nucleus to periphery
• Occasionally fatty cysts are formed
FATTY CHANGE - HEART
• Occurs due to prolonged moderate hypoxia as in
• In case of infectious myocarditis like of diphtheria.
• Bands of yellow myocardium alternating with bands of
darker red brown uninvolved myocardium
• Tigered effect
• Intracellular deposits of fat
CHOLESTEROL AND CHOLESTEROL ESTERS
• Atheromatous plaque
Most common is carbon (coal dust).
Common air pollutant.
Inhaled by macrophages within alveoli
Leads to Anthracosis (blackening of lungs)
Severe accumulation like in coal miners leads to coal
• Silicosis – Silica dust, stone and sandblasters
• Asbestosis – Asbestos dust in shipbuilding workers
• Byssinosis – Cotton dust
• Lipochrome or wear and tear pigment
• Derived through lipid peroxidation of polyunsaturated lipids of
• Telltale sign of lipid peroxidation and free radical injury
• In sections appears as yellow brown, finely granular, cytoplasmic,
often perinuclear pigment
• Seen in cells undergoing slow regressive changes as in liver and heart
of aging patients or patient with severe malnutrition or cachexia.