A. Chronic venous congestion – liver

Chronic venous congestion liver: 

The most common cause is right heart failure while the other causes include thrombosis of hepatic vein or thrombosis of inferior venacava. 

In these cases there is congestion and stasis of blood within the hepatic veins that leads to hypoxia and hemorrhagic necrosis in the centrilobular area. This is surrounded by paler zone which contains damaged hepatocytes with fatty change. While the hepatocytes adjacent to hepatic arteriole are better oxygenated and remain unaffected.  

History:

70 year-old male patient presented with distension of abdomen. 

Key Questions & Answers 

1) Describe the gross features of the specimen.

1. Specimen of enlarged and congested Liver

2. C/S shows diffuse, alternate, dark brown and yellowish white areas(Nutmeg Liver)

2) Mention the microscopic features of the given slide.

1. Dilated and congested central vein

2. Hepatocytes surrounding the central veins are necrosed (centrilobular necrosis)

3. Hepatocytes in the middle zone show fatty change

4. Peripheral hepatocytes are normal

3) Diagnose the pathological condition correlating the history, gross and microscopic features.

Chronic venous congestion of Liver

4) What are the common causes of this condition?

1. Congestive cardiac failure

2. Right ventricular failure

3. Hepatic vein thrombosis

4. Inferior vena cava obstruction

5) What is cardiac cirrhosis? 

Refers to CVC liver with cirrhosis due to right ventricular failure