Assessment of liver biopsies in obese patients: a histological and immunohistochemical study

ABSTRACT

Obesity is a multifactorial condition that involves complex interactions of metabolic, physiological, social, and behavioral factors. Obese individuals have an increased incidence of nonalcoholic fatty liver disease [NAFLD], which is one of the most common causes of chronic liver disease. However, the histological course of NAFLD remains undescribed. The aim of this study was to determine the histological course of NAFLD in obese patients. Twenty biopsies [10 from male and 10 from female patients] were obtained from obese patients and processed for histological and immunohistochemical studies. Liver biopsies from obese patients showed single or multiple fat droplets within the cytoplasm of liver cells. Ballooning of hepatocytes containing Mallory bodies showing positive immunohistochemical reactions was observed. Moreover, inflammatory cells were detected in hepatic lobules, together with hepatic cell necrosis. These changes were associated with periportal fibrosis. In patients for whom the diagnosis of NAFLD has already been made clinically, liver biopsy is performed to make the distinction between simple steatosis and steatohepatitis and also to determine the severity of liver damage within the broad spectrum of steatohepatitis. Further studies are required to determine the natural history of NAFLD and the role of liver biopsy in monitoring therapeutic responses