臨牀消化器内科 Vol.22 No.11(2)


特集名 NASH -- 最新の知見
題名 NASHの肝組織像と診断基準
発刊年月 2007年 10月
著者 岡上 武 大阪府済生会吹田病院
【 要旨 】 非アルコール性脂肪性肝疾患 (NAFLD) のなかで,炎症や線維化を伴う予後不良の疾患を非アルコール性脂肪肝炎 (NASH) と呼称するが,診断は肝生検でのみ可能である.非飲酒者で中心静脈周囲大滴性脂肪肝,肝細胞風船様変性,炎症性細胞浸潤を伴う場合NASHと診断し,しばしば中心静脈周囲性・肝細胞周囲性の線維化を伴う.Mallory body出現例もある.典型例の診断は容易であるが,肝細胞風船様変性や炎症性細胞浸潤が顕著でない例では単純性脂肪肝かNASHか診断に苦慮する.
Theme NASH : An Update
Title Histological Features and Diagnosis of NASH
Author Takeshi Okanoue Saiseikai Suita Hospital
[ Summary ] Nonalcoholic fatty liver disease (NAFLD) includes of simple steatosis and nonalcoholic steatohepatitis (NASH). NASH has various histological features, including large fatty droplets, ballooning of hepatocytes, and inflammatory cell infiltration, which are mainly noted in the pericentral area. Typically, NASH is associated with pericentral and pericellular fibrosis and Mallory body formation. However, there are some cases which show intermediate liver histology, which is between simple steatosis and NASH. These cases are difficult to produce exact diagnoses.
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