Fatty Liver

Pathologically there are two types of fatty liver: the macrovesicular type in which there are large fat deposits, and the microvesicular type. Imaging is unable to distinguish between the two types. Focal fatty liver on histology typically shows macrovesicular fat deposits. Generally, these lesions do not cause any symptoms and may be solitary or multiple. A general disposition to steatosis (see Table 2) or a localized hypoxia may be the cause, although focal fatty infiltration of the liver may also occur in patients after chemotherapy. There is a distinct disease entity called non-alcohol induced steatohepatitis (NASH) which:

Causes of steatosis hepatis

. Diabetes mellitus
• Obesity
• Kwashiorkor
• Alcohol- or drug-induced liver injury
• Chronic inflammatory bowel disease
• Hepatitis C
• Malaria
• Immotile cilia syndrome
• Fatty liver in pregnancy
• Reye’s syndrome
• Heat-stroke
• Insect bites
• Chronic hepatitis B and C in transplanted livers
• Wolman’s disease
• Chemotherapy

Causes of non-alcohol induced steatohepatitis (NASH)

• Morbid obesity
• Gastroplasty, gastro-intestinal bypass
• Diabetes mellitus type II
• Drug-induced liver injury
• Parenteral nutrition
• Weber-Christian disease
• Abetalipoproteinemia

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