Annals of R.S.C.B., Vol. XXI, Issue 3, 2017, pp. 58 - 62 doi: 10.

ANN/RSCB-2018-0005:RSCB
Received 24 March 2018; accepted 31 May 2018.

Hepatic steatosis versus normal liver in optical microscopy

ANTONELLA CHEŞCĂ (1), TIM SANDLE (2), DMITRIY BABENKO (3), ILYA AZIZOV (4)
1
Department of Basic, Preventive and Clinical Sciences,Faculty of Medicine, „Transilvania” University of Braşov,
Romania
2
Manchester University, United Kingdom
3
Karaganda State Medical University, Kazakhstan
4
Smolensk State Medical University, Russia
*Corresponding author
Antonella Chesca PhD.
Transilvania University of Brasov and at Lung Phthysiology Hospital of Brasov
E-mail: anto.chesca@gmail.com

Key words: hepatic steatosis, structural analysis, diagnosis

Summary
The aim of the study is to present structural
characteristics referring to the normal liver
comparing with structural particularities from
liver at patients diagnosed with hepatic
steatosis. For this purpose of the present
study, were analysed microscopic aspects of
hepatic structures in hepatic steatosis by
comparison with normal liver. From this point
of view, the study aims mainly observing the
hepatocyte cords and their modifications, like
lipid deposits in hepatic steatosis, and less the
presentation of vascular components, which
are not of major importance in hepatic
steatosis compared with normal liver.
It is well known that nowadays, hepatic
steatosis is one of the disease with a high
incidence at the persons from different
countries. The factors implied in developing
of hepatic steatosis, are important to know,
for a proper diagnosis of hepatic steatosis, as
non alcoholic or alcoholic form. Etiological
factor for a well establishing diagnostic as
hepatic steatosis, is metabolic syndrome
associated with other types of diseases, such
as diabetes mellitus, obesity and
dyslipidemia. There are also other factors
implied in hepatic steatosis diagnosis.
Knowing the impact of hepatic steatosis on
health, the present morphological study, show
structural characteristics to liver diagnosed
with hepatic steatosis versus structural
characteristics to normal liver.
Introduction
At present, hepatic steatosis is a common
clinical pathology. In this context,
nonalcoholic and alcoholic forms are known.
(Angulo, 2002;
Schutz , 2004). Nonalcoholic steatosis is
described as an occurrence within the
metabolic syndrome and it is associated with
other types of diseases such as diabetes
mellitus, obesity, or with the dyslipidemias
within the metabolic syndrome (Ameer, 2014;
Beylot, 1996).
On the other hand, the alcoholic steatosis is
caused by increased alcohol consumption that
leads to fat deposits in the structural
components of the liver. ( Shin, 2012; Schutz
, 2004) A favorable prognosis regarding the
patients' lives can be achieved only if alcohol
is constantly avoided (Fernando, 2013;
Hellerstein, 1999).
Laboratory investigations in conjunction
with imaging investigations lead us to the
diagnosis of hepatic steatosis (Jeffrey, 2004;
Prasad, 2012). For morphopathological
diagnostic purposes, necropsy of the liver is
carried out, both in terms of macroscopical
and microscopical analysis (Foster, 2008;
Youssef, 2000). In this context, observing the
changes that occur in the structural elements
of the liver, which is an annexed digestive
gland to the gastrointestinal tract, set the

The Romanian Society for Cell Biology ©, Annals of R. S. C. B., Vol. XXI, Issue 3, 2017, Antonella Chesca, pp. 58 – 62
58
Annals of R.S.C.B., Vol. XXI, Issue 3, 2017, pp. 58 - 62 doi: 10.ANN/RSCB-2018-0005:RSCB
Received 24 March 2018; accepted 31 May 2018.

diagnosis of hepatic steatosis (Hilden, 1997; normal liver which establishes a standard for
Livingstone, 2004). comparison facing changes occurring in the
Macroscopical analysis of the liver hepatic steatosis liver. From this point of
along with microscopical analysis of the view, on a microscopic image made in detail
autopsy liver samples, processed according to using hematoxylin-eosin staining, cords of
conventional microscopic techniques and hepatocytes and structural components of
stained to visualize the structural elements, Kiernan space, a branch of the hepatic artery
establish the correct diagnosis in this and of the portal vein and the bile duct can be
pathology (Wacholder et.al., 2004). From this observed. (Figure nr.1)
point of view, it should be noted that in
patient related associated pathology
conditions, hepatic steatosis may progress,
leading to cirrhosis or hepatoma (Horton,
2002; Hou, 2011).
Certainly, in any of the forms
mentioned in this pathology, structural
analysis is able to determine a certain
pathological diagnosis (Borecki et.al.,1998).

Materials and methods

The purpose of this study is to present by

comparison the structural elements of the
normal liver with pathological characteristics
in hepatic steatosis.
Following this idea and in order to carry out Fig.1. Liver. Normal. Hematoxylin –Eosin staining x
this study, liver fragments were collected 40.
post-mortem during autopsy from 10 patients Compared with the normal structural
who had associated pathologies. The appearances of the hepatocyte cords in normal
harvested liver fragments were processed for liver, hepatic steatosis is characterized by
structural pathology analysis. To this end, the lipid deposits in the hepatocytes, aspects
stages of classical histological techniques observed in microscopic detail on an image
were followed. The stained preparations were stained with van Gieson trichrome staining.
stained with normal as well as with special (Figure nr. 2)
stains. As previously mentioned, to undertake
this study we compared pathological liver
structures with normal liver fragments,
processed according to classical histological
technique.
Trial preparations were stained using
hematoxylin-eosin stains, Masson, van
Gieson, Weigert´s iron-hematoxylin. In order
to observe the preparations under the
microscope we used x40 objective Nikon
microscope for visualization.

Results and discussions

As a result of this study, the microscopic Fig. 2. Liver. Hepatic steatosis. van Gieson staining
images point out structural components of the x40.

The Romanian Society for Cell Biology ©, Annals of R. S. C. B., Vol. XXI, Issue 3, 2017, Antonella Chesca, pp. 58 – 62
59
Annals of R.S.C.B., Vol. XXI, Issue 3, 2017, pp. 58 - 62 doi: 10.ANN/RSCB-2018-0005:RSCB
Received 24 March 2018; accepted 31 May 2018.

The structural aspect of the hepatocyte cords

and the characteristically lipid deposits in
hepatic steatosis can be observed on a
microscopic section in detail, stained with
bichrome classic histological staining. (Figure
nr. 3)

Fig. 4. Liver. Normal. Masson staining x 40.

Compared with the normal microscopic

appearance of the liver and its characteristic
vascular structures illustrated earlier, the
following microscopic image shows the
structural features of hepatic steatosis,
Fig. 3. Liver. Hepatic steatosis. Hematoxylin –Eosin referring to hepatocytes and to the lipid
staining x40. deposits in the liver structures. Therewith, the
microscopic image shows the microscopic
The structural elements of the liver, the appearance of the portal vein branch. (Figure
appearance of the hepatocytes and their nr. 5)
characteristic of being binucleated,
respectively, are of major scientific interest in
diagnostic purposes for normal liver study as
well as in the pathology of hepatic steatosis.
On an image stained with Masson's trichrome
staining, these features can be eloquently
observed. On the same microscopic image the
structural elements of the Kiernan space
mentioned above can be in detail observed.
The way the autopsy piece was oriented in
order to make the microscopic preparation
allows the visualization of the difference
between the caliber and the wall thickness of
hepatic artery and of the portal vein branches.
Further on, the reagents of the Masson
staining provide an insight on the reduced size
of the bile duct and its appearance with
characteristic simple cubic epithelium.
(Figure nr. 4) Fig. 5. Liver. Hepatic steatosis. van Gieson staining x
40.

In the context of presenting normal liver

structural components including structural
elements of the Kiernan space as well as its
The Romanian Society for Cell Biology ©, Annals of R. S. C. B., Vol. XXI, Issue 3, 2017, Antonella Chesca, pp. 58 – 62
60
Annals of R.S.C.B., Vol. XXI, Issue 3, 2017, pp. 58 - 62 doi: 10.ANN/RSCB-2018-0005:RSCB
Received 24 March 2018; accepted 31 May 2018.

particularities in hepatic steatosis, the image influencing human fatness, Am J Hum Genet.,
below shows the detailed microscopic 1998, Sep;63(3):831-8.
Fernando HA, Chin HF, Ton SH, Abdul Kadir K,
appearance of the vascular structures of the Stress and Its Effects on Glucose Metabolism and
Kiernan space of a normal liver section 11β-HSD Activities in Rats Fed on a Combination
stained with Weigert´s hematoxylin iron of High-Fat and High-Sucrose Diet with
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1999 Apr;53 Suppl 1:S53-65.

Hilden M, Christoffersen P, Juhl E, Dalgaard JB. Liver

Fig. 6. Liver. Normal. Weigert iron hematoxylin
staining x 40.
Conclusions
Since hepatic steatosis is a serious disease
with currently high incidence, this encourages
us in making various studies. In this context,
the objectives of this study were to observe
the characteristics of the structural
components in hepatic steatosis, compared
with the normal liver. Following this idea, the
used stains eloquently emphasized the
requirements of the study and helped to
achieve its objectives.
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