Centrilobular necrosis explained

Centrilobular necrosis
Synonyms:	Central lobular necrosis, CN

Centrilobular necrosis (CN) is a nonspecific histopathological observation brought on by hepatotoxins like acetaminophen (paracetamol),^[1] thioacetamide, tetrachloride,^[2] cardiac hepatopathy due to acute right sided cardiac failure, and congestive hepatic injury in veno‐occlusive disease,^[3] or hypoxic injury due to ischemia.^[2] Centrilobular necrosis can also be found in those with autoimmune hepatitis.^[4] Centrilobular necrosis is characterized by necrotic hepatocytes completely encircling the central vein.^[5]

Outlook

After a single or brief exposure to a toxicant, hepatocytes that have suffered centrilobular necrosis typically heal quickly; the liver can regain its normal appearance under a microscope in about a week. Nevertheless, fibrosis, which may be slight, occurs in the previously necrotic zone surrounding the central vein when regeneration replaces the necrotic hepatocytes if sinusoidal cells and the normal scaffolding are destroyed.^[5]

See also

• Hepatotoxicity
• Ischemic hepatitis

Further reading

• Krishna . Murli . Patterns of necrosis in liver disease . Clinical Liver Disease . Ovid Technologies (Wolters Kluwer Health) . 10 . 2 . 2017 . 2046-2484 . 10.1002/cld.653 . 53–56. 30992760 . 6467231 . none.
• Misdraji . Joseph . Thiim . Michael . Graeme-Cook . Fiona M . Autoimmune Hepatitis With Centrilobular Necrosis . The American Journal of Surgical Pathology . Ovid Technologies (Wolters Kluwer Health) . 28 . 4 . 2004 . 0147-5185 . 10.1097/00000478-200404000-00006 . 471–478. 20808570 . none.

External links

• WebPath
• Forms of hepatic injury at Pathology Outlines.

Notes and References

1. Gardner . C . Exaggerated hepatotoxicity of acetaminophen in mice lacking tumor necrosis factor receptor-1 Potential role of inflammatory mediators . Toxicology and Applied Pharmacology . Elsevier BV . 192 . 2 . October 15, 2003 . 0041-008X . 10.1016/s0041-008x(03)00273-4 . 119–130. 14550746 .
2. Alison . M R . Sarraf . C E . Liver cell death: patterns and mechanisms. . Gut . BMJ . 35 . 5 . May 1, 1994 . 0017-5749 . 10.1136/gut.35.5.577 . 577–581. 8200545 . 1374735 .
3. Myers . R . Cardiac hepatopathy: Clinical, hemodynamic, and histologic characteristics and correlations . Hepatology . Ovid Technologies (Wolters Kluwer Health) . 37 . 2 . 2003 . 0270-9139 . 10.1053/jhep.2003.50062 . 393–400. 12540790 . free .
4. Hofer . H . Centrilobular necrosis in autoimmune hepatitis: a histological feature associated with acute clinical presentation . Journal of Clinical Pathology . BMJ . 59 . 3 . March 1, 2006 . 0021-9746 . 10.1136/jcp.2005.029348 . 246–249. 16505273 . 1860344 .
5. Book: Fundamentals of Toxicologic Pathology . Academic Press . Haschek, Wanda . 23 November 2009 . 208. 9780080919324 .