Question

Chronic alcoholic patient with history of increasing abdominal girth. On liver biopsy there are reddish inclusions. What are these made up of?

• A. Actin
• B. Microtubules
• C. Intermediate filaments
• D. Myofibril

Hint:

Identify the cytoskeletal protein that aggregates to form Mallory bodies in alcoholic hepatitis.

Answer 1

The Correct Option is C

Step 1: Identify the inclusions. In chronic alcoholism, liver biopsy shows reddish eosinophilic cytoplasmic inclusions known as Mallory-Denk bodies (Mallory bodies). These are a hallmark of alcoholic hepatitis.

Step 2: Determine the composition. Mallory-Denk bodies are composed of aggregates of intermediate filaments, specifically cytokeratin 8 and cytokeratin 18. Chronic alcohol exposure disrupts hepatocyte protein metabolism, causing abnormal accumulation of these cytoskeletal proteins.

Step 3: Eliminate distractors. Actin (microfilaments) and microtubules are other cytoskeletal components but are not the reddish inclusions seen here. Myofibrils are muscle contractile proteins, irrelevant to hepatic pathology.

Conclusion: The reddish inclusions in alcoholic liver disease are Mallory bodies, composed of intermediate filaments (cytokeratins 8 and 18).