Centrilobular necrosis

Other names| Central lobular necrosis, CN
Histopathology of shock liver (intermediate magnification), showing centrilobular necrosis but viable periportal hepatocytes.

Centrilobular necrosis (CN) is a nonspecific histopathological observation brought on by hepatotoxins like acetaminophen,[1] thioacetamide, paracetamol, 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]

## Contents

* 1 Outlook
* 2 See also
* 3 References
* 4 Further reading
* 5 External links

## 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

## References

1. ↑ Gardner, C (October 15, 2003). "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): 119–130. doi:10.1016/s0041-008x(03)00273-4. ISSN 0041-008X. PMID 14550746.
2. ↑ 2.0 2.1 Alison, M R; Sarraf, C E (May 1, 1994). "Liver cell death: patterns and mechanisms.". Gut (BMJ) 35 (5): 577–581. doi:10.1136/gut.35.5.577. ISSN 0017-5749. PMID 8200545.
3. ↑ Myers, R (2003). "Cardiac hepatopathy: Clinical, hemodynamic, and histologic characteristics and correlations". Hepatology (Ovid Technologies (Wolters Kluwer Health)) 37 (2): 393–400. doi:10.1053/jhep.2003.50062. ISSN 0270-9139. PMID 12540790.
4. ↑ Hofer, H (March 1, 2006). "Centrilobular necrosis in autoimmune hepatitis: a histological feature associated with acute clinical presentation". Journal of Clinical Pathology (BMJ) 59 (3): 246–249. doi:10.1136/jcp.2005.029348. ISSN 0021-9746. PMID 16505273.
5. ↑ 5.0 5.1 Haschek, Wanda (23 November 2009). Fundamentals of Toxicologic Pathology. Academic Press. pp. 208. ISBN 9780080919324. https://books.google.com/books?id=vkox3JS83k8C&pg=PA208.

## Further reading

* Krishna, Murli (2017). "Patterns of necrosis in liver disease". Clinical Liver Disease (Ovid Technologies (Wolters Kluwer Health)) 10 (2): 53–56. doi:10.1002/cld.653. ISSN 2046-2484. PMID 30992760.
* Misdraji, Joseph; Thiim, Michael; Graeme-Cook, Fiona M (2004). "Autoimmune Hepatitis With Centrilobular Necrosis". The American Journal of Surgical Pathology (Ovid Technologies (Wolters Kluwer Health)) 28 (4): 471–478. doi:10.1097/00000478-200404000-00006. ISSN 0147-5185.

## External links

* WebPath
* Forms of hepatic injury at Pathology Outlines.

Classification|

* ICD-11: DB97.Y
* ICD-10: K72.9
* ICD-9-CM: 572.8
* SNOMED CT: 13923006

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External resources|

* Scholia: Q19720556

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