Alcoholic Liver Disease 3

Question

Vignette: A 55-year-old man presents to the clinic with a 3-month history of weight loss, anorexia, and dark-colored urine. He also reports a 30-year history of heavy alcohol consumption. His physical examination is remarkable for jaundice, hepatomegaly, and ascites. His serum alpha-fetoprotein level is significantly elevated. A liver biopsy is performed, and the pathology report describes the presence of abundant eosinophilic, globular inclusions within the cytoplasm of hepatocytes. These inclusions are thought to represent what type of cellular change?

Choices

A) Apoptosis

B) Autophagy

C) Dysplasia

D) Hydropic swelling

E) Mallory bodies

F) Metaplasia

Answer

E) Mallory bodies

Explanation

The patient's history of chronic alcohol consumption, clinical presentation, and laboratory findings are highly suggestive of alcoholic hepatitis, a condition that may progress to cirrhosis in the setting of continued alcohol use. The globular, eosinophilic inclusions described in the pathology report are known as Mallory bodies, which are characteristic of alcoholic liver disease. Mallory bodies are composed of tangled intermediate filaments and ubiquitin, and they represent hepatocellular injury. Although the exact role of Mallory bodies in hepatocellular injury is unclear, their presence is thought to reflect a defect in protein degradation.