Image Based Question – 73791

A liver biopsy reveals following findings. What is true about this condition?

A. Nutmeg liver with dark areas of perivenular dead hepatocytes and gray areas of periportal viable hepatocytes.

B. Nodular regenerative hyperplasia of liver induced due to OC Ps.

C. Nutmeg liver with pale areas of necrosis and dark congested areas of perivenular viable hepatocytes.

D. Cirrhotic liver with fibrotic nodules.

Correct Answer » A Explanation

Ans: A. Nutmeg liver with dark areas of perivenular dead hepatocytes and gray areas of periportal viable hepatocytes

(Ref Robbins 9,/e p864, 8/e p872)

Nutmeg liver – Classical picture:

• Seen in chronic passive venous congestion on liver.
• Dark congested areas – Necrotic hepatocytes.
• Surrounding paler & brownish appearing regions – Viable hepatocytes.
• Centrilobular hemorrhagic necrosis – Due to combined hypoperfusion & retrograde congestion acting synergistically.
• Variegated mottled appearance of liver – Reflecting hemorrhage & necrosed centrilobular regions.
• Referred as “nutmeg liver” – Due to its resemblance to cut surface of nutmeg.