The pathological changes as size, weight of liver, focal necrosis, zonal necrosis and acute hepatitis were ten to twenty percent reversible in experimental groups at 30th day.
12,13 Histological examination showed that there was swelling of hepatocytes, focal necrosis, zonal necrosis and ballooning degenerations.
Another interesting observation was regarding the pattern of severity of zonal necrosis on day 15th as compared to 30th day.
The US DILIN recognizes 18 distinct histologic damage categories: acute hepatitic, chronic hepatitic, acute cholestatic (Figure 3), chronic cholestatic (Figure 4, A and B), cholestatic-hepatitic, granulomatous, macrovesicular steatotic, microvesicular steatotic, steatohepatitic (Figure 5), zonal necrosis (Figure 1), nonzonal necrosis, vascular injury (Figure 6, A and B), hepatocellular alteration, nodular regenerative hyperplasia (Figure 7), mixed or unclassified injury, minimal nonspecific changes, absolutely normal, and massive necrosis.
An injury pattern that shows zonal necrosis suggests the involvement of zonally distributed enzymes in the pathogenesis.
Zonal necrosis Coagulative Acetaminophen hepatocyte necrosis within 1 of the 3 zones of the liver acinar unit (zone 3 is most common).