A 45-year-old alcoholic man develops hepatomegaly. Liver biopsy shows hepatocytes with irregular pink cytoplasmic inclusions that stain with ubiquitin antibody (IHC). Ultrastructurally, these consist of intermediate filament aggregates. These inclusions are:

• A Ground-glass inclusions of HBsAg in endoplasmic reticulum
• B Mallory-Denk bodies (alcoholic hyaline) — aggregates of ubiquitinated cytokeratin 8/18 ✓
• C Councilman bodies — acidophilic bodies from apoptotic hepatocytes
• D Lafora bodies — polyglucosan inclusions in hepatocytes

Explanation

Mallory-Denk bodies (formerly Mallory bodies or alcoholic hyaline) are irregular eosinophilic cytoplasmic inclusions in damaged hepatocytes, composed of aggregated, hyperphosphorylated, ubiquitinated cytokeratin 8 and 18 intermediate filaments together with p62 (sequestosome-1). They are most characteristic of alcoholic hepatitis but also occur in NASH, primary biliary cholangitis, and Wilson's disease. Ground-glass inclusions of HBsAg reflect HBsAg accumulation in smooth ER. Councilman bodies are round eosinophilic apoptotic hepatocytes, classically described in yellow fever.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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