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The Clinicopathologic Spectrum and Management of Nonalcoholic Fatty Liver Disease

Contos, Melissa J.*; Sanyal, Arun J.

Advances in Anatomic Pathology: January 2002 - Volume 9 - Issue 1 - p 37-51
Review Articles And Mini Reviews

Nonalcoholic fatty liver disease (NAFD) comprises a spectrum of conditions characterized by the presence of predominantly macrovesicular fatty change in the liver and the absence of alcohol consumption in amounts considered detrimental to the liver. The histologic spectrum of NAFLD includes fatty liver alone or steatohepatitis (NASH). Nonalcoholic steatohepatitis is associated with increasing fibrosis is some cases and may progress to cirrhosis. Nonalcoholic fatty liver disease is often associated with insulin resistance. It is likely that there are one or more additional pathophysiologic defects in those with NASH, rendering them more susceptible to injury from oxidative stress. The clinical and histologic features of NASH are described, and an approach to the diagnosis and treatment of NAFLD is provided.

*Department of Pathology and †Division of Gastroenterology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia, U.S.A.

Address correspondence and reprint requests to Melissa J. Contos, M.D., MCV Box 980662 Medical College of Virginia, Richmond, VA 23298–0662. E-mail:

Supported in part by grant DK 02755–02 from the National Institutes of Health (A.J.S.).

© 2002 Lippincott Williams & Wilkins, Inc.