Morphological features and probable mode of evolution of cirrhosis of the liver in adults in North India
Aikat, B.K.; Ghosh, R.N.; Chhuttani, P.N.; Dutta, D.V.
Indian Journal of Medical Research 63(12): 1747-1760
1975
ISSN/ISBN: 0019-5340 PMID: 1225833 Document Number: 83508
Cases (250) of cirrhosis of the liver, 92 from autopsy and 158 from biopsy material, were critically analyzed. They were classified into macronodular (60.4%), micronodular (15.6%), mixed (11.2%) and unclassified end-stage diseases (3.2%). Atrophy of left lobe was observed in 35.3% of macronodular cirrhosis and was not observed in the micronodular variety. Fatty change was observed in most of the micronodular cirrhosis (69.3%) and among alcoholics (80%). Fatty metamorphosis was also present in other types of cirrhosis. Mallory's hyaline was observed most frequently in the alcoholics; it was also observed in non-alcoholic cirrhosis. A combination of steatosis, steatonecrosis and Mallory's hyaline along with satellitosis was morphological evidence of alcoholic cirrhosis with alcoholic hepatitis. Chronic alcoholism (from clinical history and morphology) was responsible for 25.2% of the cirrhotics. Significant past history of jaundice was observed in 20.4% of cases. Chronic aggressive hepatitis as a sequelae of viral hepatitis was observed in 25.9% of cases of hepatitis during the same period. Both these factors indicated viral etiology in some cases. There was no suggestion of a cause and effect relationship between protein-calorie malnutrition and cirrhosis of the liver. In 55% of the cases, it was impossible to suggest a definite etio-pathogenesis of the disease. The possible etiological factors are discussed.