This document discusses fatty change or steatosis, which describes the abnormal accumulation of triglycerides within parenchymal cells due to an overload of fat and carbohydrates. Causes include alcohol abuse, protein malnutrition, obesity, diabetes, starvation, and toxins. Fatty liver or hepatic steatosis is a reversible condition where large triglyceride molecules accumulate in liver cells, and can be either alcoholic fatty liver disease or nonalcoholic fatty liver disease associated with diabetes and obesity. On gross examination, the liver is enlarged, yellow, and greasy to touch. Microscopically, fat appears as clear areas in hepatocytes ranging from small early vacuoles to large vacuoles pushing the nucleus

1. FATTY CHANGE
PATHOLOGY PRACTICAL
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2. Fatty change/steatosis
 Describes abnormal accumulation of triglycerides
within parenchymal cells.it is an error of metabolism
in which increased intestinal uptake of fats and
carbohydrates overloads the fat transport and
breakdown system resulting in deposition of large
droplets of oil in the liver and renal parenchyma
 Causes:
 Alcohol abuse
 Protein malnutrition
 Obesity
 DM
 Anorexia(starvation)
 Toxins (CCL4, chloroform, ether)
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3. Fatty liver/Hepatic steatosis
 Also known as fatty liver disease
 Reversible condition where large molecules
of triglycerides accumulate in the liver cells
 Two main types:
 1) Alcoholic fatty liver disease (AFLD)
 2)Nonalcoholic fatty liver disease (NAFLD):
Associated with diabetes and obesity
 Can progress to steatohepatitis and
ultimately cirrhosis which are irreversible
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5. GROSS
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6.  Liver is enlarged and yellow
 Capsule is tense and glistening
 The cut surface is pale yellow
and greasy to touch
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7. MICROSCOPY
 Fat in the cytoplasm of hepatocytes appears
as a clear area
 At beginning, hepatocytes present small fat
vacuoles around the nucleus (microvesicular
fatty change)
 In later stages, size of vacuoles increases,
pushing the nucleus to the periphery of the
cell, giving characteristic signet ring
appearance (macrovesicular fatty change)
 Sometimes fatty cysts are produced by
rupture of adjacent hepatocytes containing
fat
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9. A) NORMAL LIVER B) FATTY LIVER 9

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