Pathology Spotlight- The Hidden Scar: Cirrhosis of the Liver


Cirrhosis of the Liver

The cut surface of this liver shows the typical nodular appearance of cirrhosis. Cirrhosis is a chronic disease of the liver arising from a number of causes, the best- known of which are excess alcohol consumption and infection with hepatitis B and C viruses. However cirrhosis can arise in other scenarios where there is damage to the liver such as blockage of the flow of bile from the liver, heart disease and in some inherited diseases. In alcoholic cirrhosis the large quantity of alcohol that is being processed in the liver results in damage and death of liver cells whilst viral infection causes the same effect. The liver responds with regeneration of new centres of  liver cells surrounded by bands of scarring which  gives the nodules their characteristic knobbly structure.

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“Microscopical Section of Cirrhotic Liver” image courtesy of Wikimedia Commons

This process can be clearly seen in the microscopical section of cirrhotic liver shown above. The areas of regenerated  liver cells are red and are surrounded by thick bands of scar tissue which are stained green. This pathological remodelling of the normal liver structure leads to abnormalities in the flow of blood through the organ which can culminate in impaired liver function, increased blood pressure and liver cancer.

Liver disease is the only major cause of death still increasing year-on-year and liver disease is the fifth ‘big killer’ in England & Wales, after heart, cancer, stroke and respiratory disease.  In the UK 16,087 people died from liver disease in 2008. However this only covers death and since people can survive, whilst feeling unwell , with a considerable degree of liver disease, the amount of ill health caused by liver disease is substantially greater than would appear from mortality figures alone. Liver transplantation offers the prospect of cure where cirrhosis has advanced sufficiently to cause liver failure. In order to avoid liver damage and cirrhosis, current UK government guidelines recommend that individual alcohol consumption should be no more than 14 units per week.

Learn more about Cirrhosis from the NHS Choices site

Find out more about Hepatitis on the World Hepatitis Day website


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