View source for Medicine:Centrilobular necrosis

{{Infobox medical condition
| name          = Centrilobular necrosis
| synonyms      = Central lobular necrosis, CN
| image         = Histopathology of early centrilobular hepatic necrosis of shock liver (intermediate magnification).jpg
| caption       = [[Medicine:Histopathology|Histopathology]] of [[Medicine:Ischemic hepatitis|shock liver]] (intermediate magnification), showing centrilobular necrosis but viable periportal [[Biology:Hepatocyte|hepatocyte]]s.
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'''Centrilobular necrosis''' (CN) is a nonspecific [[Medicine:Histopathology|histopathological]] observation brought on by [[Medicine:Hemotoxin|hepatotoxins]] like acetaminophen,<ref name="Exaggerated hepatotoxicity of acetaminophen">{{cite journal | last=Gardner | first=C | title=Exaggerated hepatotoxicity of acetaminophen in mice lacking tumor necrosis factor receptor-1 Potential role of inflammatory mediators | journal=Toxicology and Applied Pharmacology | publisher=Elsevier BV | volume=192 | issue=2 | date=October 15, 2003 | issn=0041-008X | doi=10.1016/s0041-008x(03)00273-4 | pages=119–130| pmid=14550746 }}</ref> [[Chemistry:Thioacetamide|thioacetamide]], [[Chemistry:Paracetamol|paracetamol]], tetrachloride,<ref name="Liver cell death">{{cite journal | last1=Alison | first1=M R | last2=Sarraf | first2=C E | title=Liver cell death: patterns and mechanisms. | journal=Gut | publisher=BMJ | volume=35 | issue=5 | date=May 1, 1994 | issn=0017-5749 | doi=10.1136/gut.35.5.577 | pages=577–581| pmid=8200545 | pmc=1374735 }}</ref> cardiac hepatopathy due to acute right sided [[Medicine:Heart failure|cardiac failure]], and congestive hepatic injury in [[Medicine:Hepatic veno-occlusive disease|veno‐occlusive disease]],<ref name="Cardiac hepatopathy">{{cite journal | last=Myers | first=R | title=Cardiac hepatopathy: Clinical, hemodynamic, and histologic characteristics and correlations | journal=Hepatology | publisher=Ovid Technologies (Wolters Kluwer Health) | volume=37 | issue=2 | year=2003 | issn=0270-9139 | doi=10.1053/jhep.2003.50062 | pages=393–400| pmid=12540790 | doi-access=free }}</ref>  or hypoxic injury due to [[Medicine:Ischemia|ischemia]].<ref name="Liver cell death"/> Centrilobular necrosis can also be found in those with [[Medicine:Autoimmune hepatitis|autoimmune hepatitis]].<ref name="Hofer 2006 pp. 246–249">{{cite journal | last=Hofer | first=H | title=Centrilobular necrosis in autoimmune hepatitis: a histological feature associated with acute clinical presentation | journal=Journal of Clinical Pathology | publisher=BMJ | volume=59 | issue=3 | date=March 1, 2006 | issn=0021-9746 | doi=10.1136/jcp.2005.029348 | pages=246–249| pmid=16505273 | pmc=1860344 }}</ref> Centrilobular necrosis is characterized by necrotic [[Biology:Hepatocyte|hepatocyte]]s completely encircling the central vein.<ref name=book>{{cite book |url=https://books.google.com/books?id=vkox3JS83k8C&pg=PA208 | title=Fundamentals of Toxicologic Pathology | publisher=Academic Press | author=Haschek, Wanda | date=23 November 2009 | pages=208| isbn=9780080919324 }}</ref>

== Outlook ==
After a single or brief exposure to a toxicant, [[Biology:Hepatocyte|hepatocyte]]s that have suffered centrilobular necrosis typically heal quickly; the [[Biology:Liver|liver]] can regain its normal appearance under a microscope in about a week. Nevertheless, [[Medicine:Fibrosis|fibrosis]], which may be slight, occurs in the previously necrotic zone surrounding the central vein when regeneration replaces the necrotic [[Biology:Hepatocyte|hepatocyte]]s if sinusoidal cells and the normal scaffolding are destroyed.<ref name=book/>

== See also ==
* [[Medicine:Hepatotoxicity|Hepatotoxicity]]
* [[Medicine:Ischemic hepatitis|Ischemic hepatitis]]

== References ==
{{reflist}}

== Further reading ==
* {{cite journal | last=Krishna | first=Murli | title=Patterns of necrosis in liver disease | journal=Clinical Liver Disease | publisher=Ovid Technologies (Wolters Kluwer Health) | volume=10 | issue=2 | year=2017 | issn=2046-2484 | doi=10.1002/cld.653 | pages=53–56| pmid=30992760 | pmc=6467231 |ref=none}}
* {{cite journal | last1=Misdraji | first1=Joseph | last2=Thiim | first2=Michael | last3=Graeme-Cook | first3=Fiona M | title=Autoimmune Hepatitis With Centrilobular Necrosis | journal=The American Journal of Surgical Pathology | publisher=Ovid Technologies (Wolters Kluwer Health) | volume=28 | issue=4 | year=2004 | issn=0147-5185 | doi=10.1097/00000478-200404000-00006 | pages=471–478| s2cid=20808570 |ref=none}}

== External links ==
* [https://webpath.med.utah.edu/LIVEHTML/LIVER043.html WebPath]
* [https://www.pathologyoutlines.com/topic/liverpatternshepaticinjury.html Forms of hepatic injury] at [https://www.pathologyoutlines.com/ Pathology Outlines].

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[[Category:Necrosis]]

{{Sourceattribution|Centrilobular necrosis|1}}