Question

Pathological manifestation of chronic alcoholism includes all of the following except -

• A. Piecemeal necrosis
• B. Ballooning degeneration
• C. Microvesicular fatty changes
• D. Central hyaline sclerosis

Hint:

Which change marks chronic active hepatitis at the portal interface, not alcohol injury?

Answer 1

The Correct Option is A

Step 1: This is an except question, so identify the feature that does NOT belong to alcoholic liver disease. The spectrum of alcoholic liver injury runs from steatosis to alcoholic hepatitis to cirrhosis.

Step 2: Steatosis shows microvesicular fatty change that later becomes macrovesicular, so option 3 is a genuine alcohol-related change. Alcoholic hepatitis shows hepatocellular necrosis, ballooning degeneration, Mallory bodies and neutrophilic infiltration, so option 2 fits. Perivenular and perisinusoidal fibrosis around the central vein gives central hyaline sclerosis, so option 4 fits.

Step 3: Piecemeal necrosis (interface hepatitis) is the destruction of hepatocytes at the limiting plate by lymphocytes. It is the hallmark of chronic active hepatitis, typically viral or autoimmune, not of alcohol.

Step 4: Therefore the feature that is not a manifestation of chronic alcoholism is piecemeal necrosis.