With an overdose of APAP, humans, rats and mice developed acute liver injury that is characterized by centrilobular
necrosis and elevation of serum liver enzymes, such as alanine aminotransferase (ALT) (Jaeschke and Bajt 2006; Fannin et al.
Marked histopathological changes as sinusoids, centrilobular
vein and portal vessels congestion were seen in this material, quite similar to those observed in rabbits by Tandon et al.
Increases in liver weight, increases in serum levels of liver enzymes, centrilobular
necrosis, fatty degeneration, hemosiderin-laden macrophages, and hemorrhage were seen in animals exposed to HC [ATSDR 1997; Fowler 1969; Gorzinski 1985; National Toxicology Program (NTP) 1989; Weeks et al.
The principal treatment-related histopathologic finding was centrilobular
necrosis evident in 5 of 5 rats at 18 h postdose.
Lobular areas of decreased attenuation and vascularity (Figure 1, E and F) are described in approximately 80% of patients, with poorly defined centrilobular
nodules in approximately 50% of patients.
High- resolution computed tomography of inflation-fixed lungs: pathologic-radiologic correlation of centrilobular
In asthmatics, moderate-to-severe central bronchiectasis affecting 3 or more lobes, bronchial wall thickening, mucoid impaction, and centrilobular
lung nodules are suggestive of allergic bronchopulmonary aspergillosis (ABPA) (Figure 2).
APAP in excessive doses has a potential to cause a fatal hepatotoxicity due to hepatic centrilobular
necrosis and has become an important problem (Larson et al.
The histopathologic findings reveal discrete nonnecrotizing granulomas with centrilobular
and bronchiolocentric distribution.
The livers showed centrilobular
necrosis, with some inflammatory cellular infiltration and prominent inclusion bodies in the hepatocytes (Figure 2B).
Acetaminophen is hepatotoxic in doses sufficient to deplete glutathione reserves, permitting accumulation of the highly reactive intermediate n-acetyl-p-benzoquinoneimine, which binds to the hepatocellular membrane, and the resulting injury precipitates centrilobular
The "classic" or characteristic findings include centrilobular
ground-glass or nodular opacities with evidence of air-trapping in the mid to upper portion of the lung lobes.