Centrilobular necrosis refers to the death of liver cells (hepatocytes) around the central vein of a liver lobule. This condition is characterized by the destruction of cells in the centrilobular zone, often due to impaired blood flow or toxic substances. The centrilobular region is particularly susceptible because it receives blood last, making it more vulnerable to
hypoxia and toxins.
Several factors can lead to centrilobular necrosis. Common causes include:
Histological Features
On a histological level, centrilobular necrosis is identified by the following features:
Loss of hepatocytes around the central vein
Presence of
necrotic cells
Inflammatory cell infiltration
Sinusoidal congestion
Possible fibrosis in chronic cases
Diagnosis of centrilobular necrosis often involves a combination of clinical symptoms, imaging studies, and
liver biopsy. Histological examination of the liver biopsy remains the gold standard for diagnosis. Stains like Hematoxylin and Eosin (H&E) are commonly used to visualize the damaged areas.
Symptoms of centrilobular necrosis can vary depending on the underlying cause but often include:
Jaundice
Abdominal pain
Elevated liver enzymes
Fatigue
Ascites in severe cases
Importance of Early Detection
Early detection of centrilobular necrosis is crucial for effective treatment and prevention of further liver damage. Identifying the underlying cause, such as toxin exposure or hypoxia, allows for targeted therapy that can prevent progression to more severe liver diseases like
cirrhosis or
liver failure.
Treatment Options
Treatment primarily focuses on addressing the underlying cause. For example:
Discontinuation of hepatotoxic drugs
Management of heart failure to improve blood flow
Antiviral therapy for viral hepatitis
Supportive care including hydration and nutrition
In severe cases, liver transplantation may be considered.
Prognosis
The prognosis of centrilobular necrosis largely depends on the extent of liver damage and the effectiveness of treating the underlying cause. Early intervention can significantly improve outcomes, but severe or untreated cases can lead to chronic liver disease and liver failure.
