Mallory's degeneration seen in alcoholic liver disease is a form of?

SJH Nursing Officer - 2019

Pathology & Genetics

Easy

Appeared in: SJH Nursing Officer - 2019

Explanation

Mallory's degeneration, also known as Mallory-Denk bodies or alcoholic hyaline, is a classic example of hyaline degeneration.
The term 'hyaline' refers to a glassy, pink appearance on H&E staining, which is characteristic of these protein aggregates.
It involves the intracellular accumulation of damaged cytoskeletal intermediate filaments (prekeratin) within the liver cells (hepatocytes).
This change is a hallmark of alcoholic hepatitis but can be seen in other liver diseases as well.

Option B: Amyloid degeneration involves the extracellular deposition of abnormally folded proteins (amyloid fibrils), which form beta-pleated sheets. Mallory bodies are intracellular accumulations of cytoskeletal proteins.
Option C: Hydropic degeneration is cellular swelling caused by an influx of water due to failure of ion pumps. It does not involve the accumulation of protein aggregates like Mallory bodies.
Option D: Fatty degeneration (steatosis) is the accumulation of triglycerides within hepatocytes, forming lipid vacuoles. This is a different substance and appearance from the eosinophilic protein aggregates of Mallory bodies.

Clinical Relevance

Nursing practice connection: Knowing Classification of cellular degeneration in liver pathology helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Identifying Mallory bodies is a key diagnostic feature of alcoholic hepatitis, which helps in staging the disease and determining prognosis.
The presence of Mallory bodies is not specific to alcohol-related liver damage. Finding them in a patient who does not consume alcohol prompts a workup for other conditions like non-alcoholic steatohepatitis (NASH), Wilson's disease, or chronic cholestatic syndromes.
What if? If the biopsy showed large, clear vacuoles pushing the hepatocyte nucleus to the periphery instead of pink inclusions, the diagnosis would be macrovesicular steatosis (fatty degeneration). While also common in alcoholic liver disease, it represents a different pathological process.

How to Approach the Question

First, identify the key term in the question stem: "Mallory's degeneration".
Recall or recognize its common synonym, "alcoholic hyaline". The word "hyaline" in the synonym is a direct clue to the answer.
Scan the options to find the matching term, which is "Hyaline degeneration".
To confirm, differentiate this from the other options. Fatty degeneration involves lipids, hydropic degeneration involves water, and amyloid degeneration involves specific extracellular protein deposits. Mallory bodies are intracellular protein aggregates, fitting the description of hyaline change.

Concept Tested & Keywords

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E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed pp. 74-76, 844-846

E6 Pathology-Textbook of PATHOLOGYHarsh Mohan Part 3 (515-969) p. 111-113