Alcohol-Related Histopathology

Abstract

The effects of chronic alcohol consumption can be detected in a variety of organs using histopathological techniques. Alcoholic liver cirrhosis accompanied by hepatic steatosis is known. Both findings, fibrosis and cirrhosis of the liver, as well as the extent of hepatic steatosis, can be histopathologically evaluated for severity and classified. To these one can add – in varying grades of severity – the histopathological detection of esophageal varices, chronic blood congestion in the spleen, as well as alcoholic fibrosing pancreatitis with duct ectasia, secretory disorders, and adjacent tryptic fatty tissue necrosis. In advanced stages, hepatic cholestasis and cholemic nephrosis may be detectable. Shortly after the last instance of alcohol consumption, one sees alcoholic hyaline in liver tissue (Mallory–Denk bodies). From a differential diagnostic perspective, one should consider alcoholic cardiomyopathy, assuming appropriate macroscopic and microscopic findings are present and despite the fact that making the differential diagnostic distinction from inflammatory cardiomyopathy may be challenging. Rarer alcohol-induced findings include Mallory–Weiss syndrome, Boerhaave syndrome, and the phenomenon referred to as “black esophagus.” Uncharacteristic findings such as gastritis, erosions, and ulceration of the gastric mucosa are often found in chronic alcohol consumption.