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id="toc-Pathogenesis-sublist" class="vector-toc-list"> <li id="toc-Macrovesicular_steatosis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Macrovesicular_steatosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.1</span> <span>Macrovesicular steatosis</span> </div> </a> <ul id="toc-Macrovesicular_steatosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Microvesicular_steatosis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Microvesicular_steatosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.2</span> <span>Microvesicular steatosis</span> </div> </a> <ul id="toc-Microvesicular_steatosis-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Histology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Histology"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> 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class="mw-page-title-main">Steatosis</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. 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(fatty atrophy of muscle) that gives a seemingly hypertrophic appearance, see <a href="/wiki/Pseudohypertrophy" title="Pseudohypertrophy">pseudohypertrophy</a></div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Steatosis</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Fatty change, fatty degeneration, fatty atrophy, adipose degeneration, fatty infiltration, fatty replacement</td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Non-alcoholic_fatty_liver_disease1.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/83/Non-alcoholic_fatty_liver_disease1.jpg/220px-Non-alcoholic_fatty_liver_disease1.jpg" decoding="async" width="220" height="164" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/83/Non-alcoholic_fatty_liver_disease1.jpg/330px-Non-alcoholic_fatty_liver_disease1.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/83/Non-alcoholic_fatty_liver_disease1.jpg/440px-Non-alcoholic_fatty_liver_disease1.jpg 2x" data-file-width="3460" data-file-height="2572" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data"><a href="/wiki/Micrograph" title="Micrograph">Micrograph</a> demonstrating marked (macrovesicular) steatosis in <a href="/wiki/Non-alcoholic_fatty_liver_disease" class="mw-redirect" title="Non-alcoholic fatty liver disease">non-alcoholic fatty liver disease</a>. <a href="/wiki/Masson%27s_trichrome_stain" title="Masson's trichrome stain">Masson's trichrome stain</a>.</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Gastroenterology" title="Gastroenterology">Gastroenterology</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Complication_(medicine)" title="Complication (medicine)">Complications</a></th><td class="infobox-data"><a href="/wiki/Fatty_liver_disease" title="Fatty liver disease">Fatty liver disease</a></td></tr></tbody></table> <p><b>Steatosis</b>, also called <b>fatty change</b>, is abnormal retention of fat (<a href="/wiki/Lipid" title="Lipid">lipids</a>) within a cell or organ.<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Steatosis most often affects the liver – the primary organ of <a href="/wiki/Lipid_metabolism" title="Lipid metabolism">lipid metabolism</a> – where the condition is commonly referred to as <a href="/wiki/Fatty_liver_disease" title="Fatty liver disease">fatty liver disease</a>. Steatosis can also occur in other organs, including the kidneys, heart, and muscle.<sup id="cite_ref-robspath_2-0" class="reference"><a href="#cite_note-robspath-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> When the term is not further specified (as, for example, in 'cardiac steatosis'), it is assumed to refer to the liver.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p><p>Risk factors associated with steatosis are varied, and may include <a href="/wiki/Diabetes_mellitus" class="mw-redirect" title="Diabetes mellitus">diabetes mellitus</a>, protein <a href="/wiki/Malnutrition" title="Malnutrition">malnutrition</a>, hypertension,<sup id="cite_ref-brookes_4-0" class="reference"><a href="#cite_note-brookes-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> cell <a href="/wiki/Toxin" title="Toxin">toxins</a>, obesity,<sup id="cite_ref-saadeh_5-0" class="reference"><a href="#cite_note-saadeh-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Hypoxia_(medical)" class="mw-redirect" title="Hypoxia (medical)">anoxia</a>,<sup id="cite_ref-robspath_2-1" class="reference"><a href="#cite_note-robspath-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> and <a href="/wiki/Sleep_apnea" title="Sleep apnea">sleep apnea</a>.<sup id="cite_ref-apnea_6-0" class="reference"><a href="#cite_note-apnea-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> </p><p>Steatosis reflects an impairment of the normal processes of <a href="/wiki/Biosynthesis" title="Biosynthesis">synthesis</a> and elimination of <a href="/wiki/Triglyceride" title="Triglyceride">triglyceride</a> fat. Excess lipid accumulates in <a href="/wiki/Vesicle_(biology)" class="mw-redirect" title="Vesicle (biology)">vesicles</a> that displace the <a href="/wiki/Cytoplasm" title="Cytoplasm">cytoplasm</a>. When the vesicles are large enough to distort the <a href="/wiki/Cell_nucleus" title="Cell nucleus">nucleus</a>, the condition is known as macrovesicular steatosis; otherwise, the condition is known as microvesicular steatosis. While not particularly detrimental to the cell in mild cases, large accumulations can disrupt cell constituents, and in severe cases the cell may even burst. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Pathogenesis">Pathogenesis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Steatosis&action=edit&section=1" title="Edit section: Pathogenesis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>No single mechanism leading to steatosis exists; rather, a varied multitude of pathologies disrupt normal lipid movement through the cell and cause accumulation.<sup id="cite_ref-pmid25422863_7-0" class="reference"><a href="#cite_note-pmid25422863-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> These mechanisms can be separated based on whether they ultimately cause an oversupply of lipid which can not be removed quickly enough (i.e., too much in), or whether they cause a failure in lipid breakdown (i.e., not enough used).<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (February 2023)">citation needed</span></a></i>]</sup> </p><p>Failure of lipid metabolism can also lead to the mechanisms which would normally utilise or remove lipids becoming impaired, resulting in the accumulation of unused lipids in the cell. Certain toxins, such as alcohols, <a href="/wiki/Carbon_tetrachloride" title="Carbon tetrachloride">carbon tetrachloride</a>, <a href="/wiki/Aspirin" title="Aspirin">aspirin</a>, and <a href="/wiki/Diphtheria_toxin" title="Diphtheria toxin">diphtheria toxin</a>, interfere with cellular machinery involved in lipid metabolism. In those with <a href="/wiki/Gaucher%27s_disease" title="Gaucher's disease">Gaucher's disease</a>, the <a href="/wiki/Lysosome" title="Lysosome">lysosomes</a> fail to degrade lipids and steatosis arises from the accumulation of <a href="/wiki/Glycolipid" title="Glycolipid">glycolipids</a>. Protein malnutrition, such as that seen in <a href="/wiki/Kwashiorkor" title="Kwashiorkor">kwashiorkor</a>, results in a lack of precursor <a href="/wiki/Apolipoprotein" title="Apolipoprotein">apoproteins</a> within the cell, therefore unused lipids which would normally participate in <a href="/wiki/Lipoprotein" title="Lipoprotein">lipoprotein</a> synthesis begin to accumulate.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (February 2023)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Macrovesicular_steatosis">Macrovesicular steatosis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Steatosis&action=edit&section=2" title="Edit section: Macrovesicular steatosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Macrovesicular steatosis is the more common form of fatty degeneration and may be caused by oversupply of lipids due to obesity, <a href="/wiki/Obstructive_sleep_apnea" title="Obstructive sleep apnea">obstructive sleep apnea</a> (OSA),<sup id="cite_ref-pmid20857857_8-0" class="reference"><a href="#cite_note-pmid20857857-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> insulin resistance, or <a href="/wiki/Alcoholism" title="Alcoholism">alcoholism</a>. Nutrient malnutrition may also cause the mobilisation of fat from <a href="/wiki/Adipocyte" title="Adipocyte">adipocytes</a> and create a local oversupply in the liver where lipid metabolism occurs. Excess alcohol over a long period of time can induce steatosis. The breakdown of large amounts of <a href="/wiki/Ethanol" title="Ethanol">ethanol</a> in alcoholic drinks produces large amounts of chemical energy in the form of <a href="/wiki/NADH" class="mw-redirect" title="NADH">NADH</a>, signalling to the cell to inhibit the breakdown of <a href="/wiki/Fatty_acid" title="Fatty acid">fatty acids</a> (which also produces energy) and simultaneously increase the synthesis of <a href="/wiki/Fatty_acid" title="Fatty acid">fatty acids</a>. This "false sense of energy" results in more lipid being created than is needed.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (February 2023)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Microvesicular_steatosis">Microvesicular steatosis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Steatosis&action=edit&section=3" title="Edit section: Microvesicular steatosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Histopathology_of_microvesicular_steatosis.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d7/Histopathology_of_microvesicular_steatosis.jpg/220px-Histopathology_of_microvesicular_steatosis.jpg" decoding="async" width="220" height="165" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d7/Histopathology_of_microvesicular_steatosis.jpg/330px-Histopathology_of_microvesicular_steatosis.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/d7/Histopathology_of_microvesicular_steatosis.jpg/440px-Histopathology_of_microvesicular_steatosis.jpg 2x" data-file-width="1063" data-file-height="799" /></a><figcaption>Histopathology of microvesicular steatosis, with foamy hepatocytes (two annotated by arrows), as opposed to macrovesicular steatosis (insert).</figcaption></figure> <p>Microvesicular steatosis is characterized by small intracytoplasmic fat vacuoles (liposomes) which accumulate within hepatocytes.<sup id="cite_ref-TandraYeh2011_9-0" class="reference"><a href="#cite_note-TandraYeh2011-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> It is associated with a wide variety of conditions, including <a href="/wiki/Alcoholism" title="Alcoholism">alcoholism</a>, <a href="/wiki/Drug_toxicity" class="mw-redirect" title="Drug toxicity">drug toxicity</a> of several medications, <a href="/wiki/Delta_hepatitis" class="mw-redirect" title="Delta hepatitis">delta hepatitis</a> (in South America and Central Africa), sudden childhood death, congenital defects of fatty acid <a href="/wiki/Beta_oxidation" title="Beta oxidation">beta oxidation</a>, <a href="/wiki/Cholesterol_ester_storage_disease" class="mw-redirect" title="Cholesterol ester storage disease">cholesterol ester storage disease</a>, <a href="/wiki/Wolman_disease" class="mw-redirect" title="Wolman disease">Wolman disease</a> and <a href="/wiki/Alpers_syndrome" class="mw-redirect" title="Alpers syndrome">Alpers syndrome</a>.<sup id="cite_ref-pmid2177300_10-0" class="reference"><a href="#cite_note-pmid2177300-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Histology">Histology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Steatosis&action=edit&section=4" title="Edit section: Histology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Histology" title="Histology">Histologically</a>, steatosis is physically apparent as lipid within membrane bound <a href="/wiki/Liposome" title="Liposome">liposomes</a> of <a href="/wiki/Parenchyma" title="Parenchyma">parenchymal</a> cells.<sup id="cite_ref-robspath_2-2" class="reference"><a href="#cite_note-robspath-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> When this tissue is <a href="/wiki/Staining" title="Staining">fixed and stained</a> to be better viewed under a microscope, the lipid is usually dissolved by the solvents used to prepare the sample. As such, samples prepared this way will appear to have empty holes (or vacuoles) within the cells where the lipid has been cleared. Special lipid stains, such as <a href="/wiki/Sudan_stain" title="Sudan stain">Sudan stains</a> and <a href="/wiki/Staining#Osmium_tetroxide" title="Staining">osmium tetroxide</a> are able to retain and show up lipid droplets, hence more conclusively indicating the presence of lipids. Other intracellular accumulations, such as water or <a href="/wiki/Glycogen" title="Glycogen">glycogen</a>, can also appear as clear vacuoles, therefore it becomes necessary to use stains to better determine what substance is accumulating.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (December 2024)">citation needed</span></a></i>]</sup> </p><p>Grossly, steatosis causes organ enlargement and lightening in colour.<sup id="cite_ref-robspath_2-3" class="reference"><a href="#cite_note-robspath-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> This is due to the high lipid content increasing the organ's volume and becoming visible to the unaided eye. In severe cases, the organ may become vastly enlarged, greasy, and yellow in appearance.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (December 2024)">citation needed</span></a></i>]</sup> </p> <ul class="gallery mw-gallery-traditional"> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Liver_steatosis_fatty_change.jpg" class="mw-file-description" title="Histological section of a mouse's liver showing severe steatosis. The clear vacuoles contained lipid in life; however, histological fixation caused it to be dissolved and hence only empty/clear spaces are seen."><img alt="Histological section of a mouse's liver showing severe steatosis. The clear vacuoles contained lipid in life; however, histological fixation caused it to be dissolved and hence only empty/clear spaces are seen." src="//upload.wikimedia.org/wikipedia/commons/thumb/1/19/Liver_steatosis_fatty_change.jpg/120px-Liver_steatosis_fatty_change.jpg" decoding="async" width="120" height="79" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/19/Liver_steatosis_fatty_change.jpg/180px-Liver_steatosis_fatty_change.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/19/Liver_steatosis_fatty_change.jpg/240px-Liver_steatosis_fatty_change.jpg 2x" data-file-width="730" data-file-height="480" /></a></span></div> <div class="gallerytext"><a href="/wiki/Histology" title="Histology">Histological</a> section of a mouse's liver showing severe steatosis. The clear <a href="/wiki/Vacuole" title="Vacuole">vacuoles</a> contained <a href="/wiki/Lipid" title="Lipid">lipid</a> in life; however, histological fixation caused it to be dissolved and hence only empty/clear spaces are seen.</div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Fatty_change_liver_-_Lipid_steatosis_10X.jpg" class="mw-file-description" title="Micrograph of fatty liver showing lipid steatosis. H&E stain."><img alt="Micrograph of fatty liver showing lipid steatosis. H&E stain." src="//upload.wikimedia.org/wikipedia/commons/thumb/4/46/Fatty_change_liver_-_Lipid_steatosis_10X.jpg/120px-Fatty_change_liver_-_Lipid_steatosis_10X.jpg" decoding="async" width="120" height="87" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/46/Fatty_change_liver_-_Lipid_steatosis_10X.jpg/180px-Fatty_change_liver_-_Lipid_steatosis_10X.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/46/Fatty_change_liver_-_Lipid_steatosis_10X.jpg/240px-Fatty_change_liver_-_Lipid_steatosis_10X.jpg 2x" data-file-width="750" data-file-height="546" /></a></span></div> <div class="gallerytext">Micrograph of fatty liver showing lipid steatosis. <a href="/wiki/H%26E" class="mw-redirect" title="H&E">H&E</a> stain.</div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Histopathology_of_centrilobular_steatosis_of_the_liver.jpg" class="mw-file-description" title="Steatosis with a centrilobular pattern, which is the general tendency for steatosis in adults.[11]"><img alt="Steatosis with a centrilobular pattern, which is the general tendency for steatosis in adults.[11]" src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d2/Histopathology_of_centrilobular_steatosis_of_the_liver.jpg/120px-Histopathology_of_centrilobular_steatosis_of_the_liver.jpg" decoding="async" width="120" height="98" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d2/Histopathology_of_centrilobular_steatosis_of_the_liver.jpg/180px-Histopathology_of_centrilobular_steatosis_of_the_liver.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/d2/Histopathology_of_centrilobular_steatosis_of_the_liver.jpg/240px-Histopathology_of_centrilobular_steatosis_of_the_liver.jpg 2x" data-file-width="1489" data-file-height="1217" /></a></span></div> <div class="gallerytext">Steatosis with a <i>centrilobular</i> pattern, which is the general tendency for steatosis in adults.<sup id="cite_ref-BenedictZhang2017_11-0" class="reference"><a href="#cite_note-BenedictZhang2017-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup></div> </li> </ul> <div class="mw-heading mw-heading2"><h2 id="Medical_imaging">Medical imaging</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Steatosis&action=edit&section=5" title="Edit section: Medical imaging"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Liversteatosis.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/d/df/Liversteatosis.png/220px-Liversteatosis.png" decoding="async" width="220" height="184" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/df/Liversteatosis.png/330px-Liversteatosis.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/df/Liversteatosis.png/440px-Liversteatosis.png 2x" data-file-width="1142" data-file-height="954" /></a><figcaption>Liver steatosis (fatty liver disease) as seen on CT</figcaption></figure> <p>On <a href="/wiki/X-ray_computed_tomography" class="mw-redirect" title="X-ray computed tomography">X-ray computed tomography</a> (CT), the increased fat component will decrease the density of the liver tissue, making the image less bright. Typically the density of the spleen and liver are roughly equivalent. In steatosis, there is a difference between the density and brightness of the two organs, with the liver appearing darker.<sup id="cite_ref-Helms_2007_12-0" class="reference"><a href="#cite_note-Helms_2007-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> On ultrasound, fat is more <a href="/wiki/Echogenicity" title="Echogenicity">echogenic</a> (capable of reflecting sound waves). The combination of liver steatosis being dark on CT and bright on ultrasound is sometimes known as the flip flop sign.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (February 2023)">citation needed</span></a></i>]</sup> </p><p>On <a href="/wiki/Magnetic_resonance_imaging" title="Magnetic resonance imaging">magnetic resonance imaging</a>, multiecho gradient echo images can be used to determine the percent fat fraction of the liver.<sup id="cite_ref-pmid22025886_13-0" class="reference"><a href="#cite_note-pmid22025886-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> The different resonance frequencies between water and fat make this technique very sensitive and accurate. Acquisition of echoes in "in phase" and "out phase" conditions (pertaining to the relative phases of the fat and water proton contingents) enables to obtain a signal proportional to the water and fat contingent, or a signal proportional to the water minus the fat contingent. These signal intensities are then algebraically combined into a percent fat. More recent techniques take into account experimental noise, signal decay and spectroscopic properties of fat. Numerous validation studies have demonstrated excellent correlations between the steatosis level quantified at MRI and the steatosis levels semi-quantitatively and quantitatively determined on liver biopsies (reference methods).<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2023)">citation needed</span></a></i>]</sup> Several MRI vendors offer automated calculation of percent fat with acquisition sequences no longer than a single breath hold.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2023)">citation needed</span></a></i>]</sup> </p><p>On <a href="/wiki/Abdominal_ultrasonography" title="Abdominal ultrasonography">abdominal ultrasonography</a>, steatosis is seen as a hyperechoic liver as compared to the normal kidney. </p> <ul class="gallery mw-gallery-packed"> <li class="gallerybox" style="width: 361.33333333333px"> <div class="thumb" style="width: 359.33333333333px;"><span typeof="mw:File"><a href="/wiki/File:MRI_Liversteatosis.jpg" class="mw-file-description" title="Liver steatosis (fatty liver disease) as seen on MRI. Multiecho MR sequence in a healthy liver (top row) and a liver with severe steatosis (bottom row) are shown. In the healthy liver, the signal does not vary much in the different echoes. In the steatotic liver, the signal varies greatly between in and out phase echoes. Algebraic combination of these images can be used to accurately quantify liver steatosis."><img alt="Liver steatosis (fatty liver disease) as seen on MRI. Multiecho MR sequence in a healthy liver (top row) and a liver with severe steatosis (bottom row) are shown. In the healthy liver, the signal does not vary much in the different echoes. In the steatotic liver, the signal varies greatly between in and out phase echoes. Algebraic combination of these images can be used to accurately quantify liver steatosis." src="//upload.wikimedia.org/wikipedia/commons/thumb/3/37/MRI_Liversteatosis.jpg/539px-MRI_Liversteatosis.jpg" decoding="async" width="360" height="190" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/37/MRI_Liversteatosis.jpg/809px-MRI_Liversteatosis.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/37/MRI_Liversteatosis.jpg/1077px-MRI_Liversteatosis.jpg 2x" data-file-width="1351" data-file-height="715" /></a></span></div> <div class="gallerytext">Liver steatosis (fatty liver disease) as seen on MRI. Multiecho MR sequence in a healthy liver (top row) and a liver with severe steatosis (bottom row) are shown. In the healthy liver, the signal does not vary much in the different echoes. In the steatotic liver, the signal varies greatly between in and out phase echoes. Algebraic combination of these images can be used to accurately quantify liver steatosis.</div> </li> <li class="gallerybox" style="width: 370.66666666667px"> <div class="thumb" style="width: 368.66666666667px;"><span typeof="mw:File"><a href="/wiki/File:False_impression_of_hyperechogenic_liver.jpg" class="mw-file-description" title="Abdominal ultrasonography with the liver and kidney side by side (left image) may give a false impression of hyperechogenic liver, so it's preferably done with the organ borders facing the ultrasound probe (right image, of the same case)."><img alt="Abdominal ultrasonography with the liver and kidney side by side (left image) may give a false impression of hyperechogenic liver, so it's preferably done with the organ borders facing the ultrasound probe (right image, of the same case)." src="//upload.wikimedia.org/wikipedia/commons/thumb/6/6f/False_impression_of_hyperechogenic_liver.jpg/553px-False_impression_of_hyperechogenic_liver.jpg" decoding="async" width="369" height="190" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/6f/False_impression_of_hyperechogenic_liver.jpg/831px-False_impression_of_hyperechogenic_liver.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/6f/False_impression_of_hyperechogenic_liver.jpg/1106px-False_impression_of_hyperechogenic_liver.jpg 2x" data-file-width="1511" data-file-height="779" /></a></span></div> <div class="gallerytext"><a href="/wiki/Abdominal_ultrasonography" title="Abdominal ultrasonography">Abdominal ultrasonography</a> with the liver and kidney side by side (left image) may give a false impression of hyperechogenic liver, so it's preferably done with the organ borders facing the ultrasound probe (right image, of the same case).</div> </li> <li class="gallerybox" style="width: 184px"> <div class="thumb" style="width: 182px;"><span typeof="mw:File"><a href="/wiki/File:Ultrasonography_of_focal_steatosis.jpg" class="mw-file-description" title="Abdominal ultrasonography of focal steatosis. It is distinguished from a tumor by not compressing the hepatic vein."><img alt="Abdominal ultrasonography of focal steatosis. It is distinguished from a tumor by not compressing the hepatic vein." src="//upload.wikimedia.org/wikipedia/commons/thumb/0/05/Ultrasonography_of_focal_steatosis.jpg/273px-Ultrasonography_of_focal_steatosis.jpg" decoding="async" width="182" height="190" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/05/Ultrasonography_of_focal_steatosis.jpg/410px-Ultrasonography_of_focal_steatosis.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/05/Ultrasonography_of_focal_steatosis.jpg/546px-Ultrasonography_of_focal_steatosis.jpg 2x" data-file-width="636" data-file-height="664" /></a></span></div> <div class="gallerytext"><a href="/wiki/Abdominal_ultrasonography" title="Abdominal ultrasonography">Abdominal ultrasonography</a> of focal steatosis. It is distinguished from a tumor by not compressing the <a href="/wiki/Hepatic_vein" class="mw-redirect" title="Hepatic vein">hepatic vein</a>.</div> </li> </ul> <div class="mw-heading mw-heading2"><h2 id="Incidence">Incidence</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Steatosis&action=edit&section=6" title="Edit section: Incidence"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div><p> In <a href="/wiki/Bristol_University" class="mw-redirect" title="Bristol University">Bristol University</a>'s study <a href="/wiki/Children_of_the_90s" class="mw-redirect" title="Children of the 90s">Children of the 90s</a>, 2.5% of 4,000 people born in 1991 and 1992 were found by ultrasound scanning at the age of 18 to have <a href="/wiki/Non-alcoholic_fatty_liver_disease" class="mw-redirect" title="Non-alcoholic fatty liver disease">non-alcoholic fatty liver disease</a>; five years later <a href="/wiki/Transient_elastography" class="mw-redirect" title="Transient elastography">transient elastography</a> (fibroscan) found over 20% to have the fatty deposits on the liver of steatosis, indicating non-alcoholic fatty liver disease; half of those were classified as severe. The scans also found that 2.4% had the liver scarring of <a href="/wiki/Fibrosis" title="Fibrosis">fibrosis</a>, which can lead to <a href="/wiki/Cirrhosis" title="Cirrhosis">cirrhosis</a>.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup><style data-mw-deduplicate="TemplateStyles:r1235681985">.mw-parser-output .side-box{margin:4px 0;box-sizing:border-box;border:1px solid #aaa;font-size:88%;line-height:1.25em;background-color:var(--background-color-interactive-subtle,#f8f9fa);display:flow-root}.mw-parser-output .side-box-abovebelow,.mw-parser-output .side-box-text{padding:0.25em 0.9em}.mw-parser-output .side-box-image{padding:2px 0 2px 0.9em;text-align:center}.mw-parser-output .side-box-imageright{padding:2px 0.9em 2px 0;text-align:center}@media(min-width:500px){.mw-parser-output .side-box-flex{display:flex;align-items:center}.mw-parser-output .side-box-text{flex:1;min-width:0}}@media(min-width:720px){.mw-parser-output .side-box{width:238px}.mw-parser-output .side-box-right{clear:right;float:right;margin-left:1em}.mw-parser-output .side-box-left{margin-right:1em}}</style><style data-mw-deduplicate="TemplateStyles:r1237033735">@media print{body.ns-0 .mw-parser-output .sistersitebox{display:none!important}}@media screen{html.skin-theme-clientpref-night .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-en-v2.svg"]{background-color:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-en-v2.svg"]{background-color:white}}</style></p><div class="side-box side-box-right plainlinks sistersitebox"><style data-mw-deduplicate="TemplateStyles:r1126788409">.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style> <div class="side-box-flex"> <div class="side-box-image"><span class="noviewer" typeof="mw:File"><span><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/30px-Commons-logo.svg.png" decoding="async" width="30" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/45px-Commons-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/59px-Commons-logo.svg.png 2x" data-file-width="1024" data-file-height="1376" /></span></span></div> <div class="side-box-text plainlist">Wikimedia Commons has media related to <span style="font-weight: bold; font-style: italic;"><a href="https://commons.wikimedia.org/wiki/Category:Elastography" class="extiw" title="commons:Category:Elastography">Elastography</a></span>.</div></div> </div> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Steatosis&action=edit&section=7" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Fatty_liver_disease" title="Fatty liver disease">Fatty liver disease</a></li> <li><a href="/wiki/Lipid_metabolism" title="Lipid metabolism">Lipid metabolism</a></li> <li><a href="/wiki/Non-alcoholic_fatty_liver_disease" class="mw-redirect" title="Non-alcoholic fatty liver disease">Non-alcoholic fatty liver disease</a></li> <li><a href="/wiki/Visceral_fat" class="mw-redirect" title="Visceral fat">Visceral fat</a></li> <li><a href="/wiki/Fat_globules" class="mw-redirect" title="Fat globules">Fat globules</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Steatosis&action=edit&section=8" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.thefreedictionary.com/steatosis">"steatosis"</a>. <i>Farlex Dictionary</i><span class="reference-accessdate">. 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(November 2015)">page needed</span></a></i>]</sup></span> </li> <li id="cite_note-pmid22025886-13"><span class="mw-cite-backlink"><b><a href="#cite_ref-pmid22025886_13-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFReederCruiteHamiltonSirlin2011" class="citation journal cs1">Reeder SB, Cruite I, Hamilton G, Sirlin CB (October 2011). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3177109">"Quantitative Assessment of Liver Fat with Magnetic Resonance Imaging and Spectroscopy"</a>. <i>J Magn Reson Imaging</i>. <b>34</b> (4): 729–749. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Fjmri.22775">10.1002/jmri.22775</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" 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title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=J+Magn+Reson+Imaging&rft.atitle=Quantitative+Assessment+of+Liver+Fat+with+Magnetic+Resonance+Imaging+and+Spectroscopy&rft.volume=34&rft.issue=4&rft.pages=729-749&rft.date=2011-10&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3177109%23id-name%3DPMC&rft_id=info%3Apmid%2F22025886&rft_id=info%3Adoi%2F10.1002%2Fjmri.22775&rft.aulast=Reeder&rft.aufirst=SB&rft.au=Cruite%2C+I&rft.au=Hamilton%2C+G&rft.au=Sirlin%2C+CB&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3177109&rfr_id=info%3Asid%2Fen.wikipedia.org%3ASteatosis" class="Z3988"></span></span> </li> <li id="cite_note-14"><span class="mw-cite-backlink"><b><a href="#cite_ref-14">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSarah_Boseley2019" class="citation web cs1">Sarah Boseley (12 April 2019). <a 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class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q1365091" class="extiw" title="d:Q1365091">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/Xxx.x">Xxx.x</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=xxx">xxx</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Pathology" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output 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.navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Pathology" title="Template:Pathology"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Pathology" title="Template talk:Pathology"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Pathology" title="Special:EditPage/Template:Pathology"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Pathology" style="font-size:114%;margin:0 4em"><a href="/wiki/Pathology" title="Pathology">Pathology</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Principles of pathology</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Disease" title="Disease">Disease</a> <ul><li><a href="/wiki/Infection" title="Infection">Infection</a></li> <li><a href="/wiki/Neoplasm" title="Neoplasm">Neoplasia</a></li> <li><a href="/wiki/Cause_(medicine)" title="Cause (medicine)">Cause</a></li> <li><a href="/wiki/Pathogenesis" title="Pathogenesis">Pathogenesis</a></li></ul></li> <li><a href="/wiki/Hemodynamics" title="Hemodynamics">Hemodynamics</a> <ul><li><a href="/wiki/Ischemia" title="Ischemia">Ischemia</a></li></ul></li> <li><a href="/wiki/Inflammation" title="Inflammation">Inflammation</a></li> <li><a href="/wiki/Cell_damage" title="Cell damage">Cell damage</a></li> <li><a href="/wiki/Wound_healing" title="Wound healing">Wound healing</a></li></ul> <dl><dt><a href="/wiki/Cellular_adaptation" title="Cellular adaptation">Cellular adaptation</a></dt> <dd></dd> <dd><a href="/wiki/Atrophy" title="Atrophy">Atrophy</a></dd> <dd><a href="/wiki/Hypertrophy" title="Hypertrophy">Hypertrophy</a></dd> <dd><a href="/wiki/Hyperplasia" title="Hyperplasia">Hyperplasia</a></dd> <dd><a href="/wiki/Dysplasia" title="Dysplasia">Dysplasia</a></dd> <dd><a href="/wiki/Metaplasia" title="Metaplasia">Metaplasia</a> <dl><dd><a href="/wiki/Squamous_metaplasia" title="Squamous metaplasia">Squamous</a></dd> <dd><a href="/wiki/Glandular_metaplasia" title="Glandular metaplasia">Glandular</a></dd></dl></dd></dl> <dl><dt><a href="/wiki/Cell_death" title="Cell death">Cell death</a></dt> <dd></dd> <dd><a href="/wiki/Necrosis" title="Necrosis">Necrosis</a> <dl><dd><a href="/wiki/Coagulative_necrosis" title="Coagulative necrosis">Coagulative necrosis</a></dd> <dd><a href="/wiki/Liquefactive_necrosis" title="Liquefactive necrosis">Liquefactive necrosis</a></dd> <dd><a href="/wiki/Gangrene" title="Gangrene">Gangrenous necrosis</a></dd> <dd><a href="/wiki/Caseous_necrosis" title="Caseous necrosis">Caseous necrosis</a></dd> <dd><a href="/wiki/Fat_necrosis" title="Fat necrosis">Fat necrosis</a></dd> <dd><a href="/wiki/Fibrinoid_necrosis" title="Fibrinoid necrosis">Fibrinoid necrosis</a></dd> <dd><a href="/wiki/Myocytolysis" title="Myocytolysis">Myocytolysis</a></dd></dl></dd> <dd><a href="/wiki/Programmed_cell_death" title="Programmed cell death">Programmed cell death</a> <dl><dd><a href="/wiki/Apoptosis" title="Apoptosis">Apoptosis</a></dd></dl></dd> <dd><a href="/wiki/Pyknosis" title="Pyknosis">Pyknosis</a></dd> <dd><a href="/wiki/Karyorrhexis" title="Karyorrhexis">Karyorrhexis</a></dd> <dd><a href="/wiki/Karyolysis" title="Karyolysis">Karyolysis</a></dd></dl> <dl><dt><i>Accumulations</i></dt> <dd><i><a href="/wiki/Pigment" title="Pigment">pigment</a></i> <dl><dd><a href="/wiki/Hemosiderin" title="Hemosiderin">Hemosiderin</a></dd> <dd><a href="/wiki/Lipochrome" class="mw-redirect" title="Lipochrome">Lipochrome</a>/<a href="/wiki/Lipofuscin" title="Lipofuscin">Lipofuscin</a></dd> <dd><a href="/wiki/Melanin" title="Melanin">Melanin</a></dd></dl></dd> <dd><a class="mw-selflink selflink">Steatosis</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anatomical_pathology" title="Anatomical pathology">Anatomical pathology</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Surgical_pathology" title="Surgical pathology">Surgical pathology</a></li> <li><a href="/wiki/Cytopathology" title="Cytopathology">Cytopathology</a></li> <li><a href="/wiki/Autopsy" title="Autopsy">Autopsy</a></li> <li><a href="/wiki/Molecular_pathology" title="Molecular pathology">Molecular pathology</a></li> <li><a href="/wiki/Forensic_pathology" title="Forensic pathology">Forensic pathology</a></li> <li><a href="/wiki/Oral_and_maxillofacial_pathology" title="Oral and maxillofacial pathology">Oral and maxillofacial pathology</a></li></ul> <ul><li><a href="/wiki/Gross_processing" title="Gross processing">Gross processing</a></li> <li><a href="/wiki/Histopathology" title="Histopathology">Histopathology</a></li> <li><a href="/wiki/Immunohistochemistry" title="Immunohistochemistry">Immunohistochemistry</a></li> <li><a href="/wiki/Electron_microscope" title="Electron microscope">Electron microscopy</a></li> <li><a href="/wiki/Immunofluorescence" title="Immunofluorescence">Immunofluorescence</a></li> <li><a href="/wiki/Fluorescence_in_situ_hybridization" title="Fluorescence in situ hybridization">Fluorescence in situ hybridization</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Clinical_pathology" title="Clinical pathology">Clinical pathology</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Clinical_chemistry" title="Clinical chemistry">Clinical chemistry</a></li> <li><a href="/wiki/Hematopathology" title="Hematopathology">Hematopathology</a></li> <li><a href="/wiki/Transfusion_medicine" title="Transfusion medicine">Transfusion medicine</a></li> <li><a href="/wiki/Medical_microbiology" title="Medical microbiology">Medical microbiology</a></li> <li><a href="/wiki/Immunoassay" title="Immunoassay">Diagnostic immunology</a></li> <li><a href="/wiki/Immunopathology" title="Immunopathology">Immunopathology</a></li></ul> <ul><li><a href="/wiki/Enzyme_assay" title="Enzyme assay">Enzyme assay</a></li> <li><a href="/wiki/Mass_spectrometry" title="Mass spectrometry">Mass spectrometry</a></li> <li><a href="/wiki/Chromatography" title="Chromatography">Chromatography</a></li> <li><a href="/wiki/Flow_cytometry" title="Flow cytometry">Flow cytometry</a></li> <li><a href="/wiki/Blood_bank" title="Blood bank">Blood bank</a></li> <li><a href="/wiki/Microbiological_culture" title="Microbiological culture">Microbiological culture</a></li> <li><a href="/wiki/Serology" title="Serology">Serology</a></li></ul> </div></td></tr></tbody></table></div>    </div><noscript><img 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