• A descriptive term for a liver with chronic
passive congestion, a hepatopathy due to
cardiac decompensation and failure.
• If the congestion is severe, these changes may
be accompanied by haemorrhagic necrosis
Microscopically, the nutmeg pattern results from congestion
around the central veins, as seen here.
This is usually due to a "right sided" heart failure
• Liver is divided histologically into lobules.
• The center of the lobule is the central vein.
• At the periphery of the lobule are portal triads.
• Functionally, the liver can be divided into
three zones, based upon oxygen supply.
• Zone 1 encircles the portal tracts where the
oxygenated blood from hepatic arteries enters.
• Zone 3 is located around central veins, where
oxygenation is poor. Zone 2 is located in
• Petechiae measure less than 3 mm.
• Purpura measure 0.3–1 cm.
• Ecchymoses greater than 1 cm.
• Here are petechial
on the epicardium
of the heart.
• Petechiae (pinpoint
from small vessels
and are classically
found when a
coagulopathy is due
to a low platelet
• They can also
• The blotchy areas of hemorrhage in the skin are
called ecchymoses (singular ecchymosis), or also as
areas of purpura.
• Ecchymoses are larger than petechiae.
• They can appear with coagulation disorders.
Thrombus - Morphology
Arise in arteries
Arise in deep veins and
superficial veins (popleteal
Grow in retrograde fashion
(towards the heart)
Forms at site of Endothelial
injury (AS), turbulence
At site of stasis (lower
Red / dark
Lines of Zahn
No lines of Zahn
• These are "lines of Zahn" which are the alternating
pale pink bands of platelets with fibrin and red
bands of RBC's forming a true thrombus.