Pathology: ischemic hepatopathy


You’re thinking to yourself, hmm, why is this slide titled ischemic hepatopathy?  You don’t see any hepatocyte necrosis.  No macrophage activity.  No inflammation.  This post is a sham!  Just a minute…

The purpose of using this histologic specimen is for its architectural perfection.  In it, you can clearly see the central vein (the white spot in the middle of the lobule).  This is zone 3 of the liver.  The parenchyma (ie. most of the pink hepatocytes) is zone 2.  The area around each of the 5 corners of the image is zone 1, or, the portal areas. 

You should recognize that zone 1 has the highest oxygen tension (pO2) because it is where blood first enters the liver.  It then passes through the sinusoids in zone 2 before reaching the central vein in zone 3.  In cases of ischemic hepatopathy, zone 3 has the poorest concentration of oxygen and therefore suffers the most damage (necrosis; hepatocyte dropout).

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