Microvesicular alcoholic steatosis. This form of steatosis occurs more rarely and consists of groups of foamy hepatocytes containing small fat droplets throughout the cytoplasm. The nuclei in these cells are centrally located. There is macrovesicular steatosis, focal necrosis and cholestasis in other areas of the same tissue but no Mallory bodies are seen. Clinically there is jaundice and elevation of alkaline phosphatase but no fever or leukocytosis like in alcoholic hepatitis.
Microvesicular changes appear to be the first stage of hepatic decompensation.
It will resolve without complications with the cessation of alcohol. Diagnosis of steatosis can be made only by liver biopsy because the liver function tests in use are usually normal. The biopsy is performed also with the intend to of detecting eventual complications such as fibrosis, inflammation etc. Uncomplicated alcoholic fatty liver or even with minimal fibrosis will return to normal in 4 to 6 weeks of abstension from alcohol. Fig.153-Alcoholic steatosis Panlobular.