A liver biopsy in a patient with NASH (non-alcoholic steatohepatitis) shows hepatocyte ballooning and Mallory-Denk bodies. The composition of Mallory-Denk bodies is:
- A Intracellular triglyceride droplets
- B Aggregates of misfolded cytokeratin 8 and 18 with ubiquitin and p62/sequestosome ✓
- C Alpha-1-antitrypsin globules in the ER
- D Hepatitis B surface antigen aggregates
Explanation
Mallory-Denk bodies (MDBs) are eosinophilic intracytoplasmic inclusions formed by aberrant aggregation of cytokeratin 8 and 18 intermediate filaments that are ubiquitinated and crosslinked, with accumulation of p62 (sequestosome-1) — a cargo-receptor for selective autophagy. They indicate impaired protein quality control and proteasomal dysfunction and are seen in alcoholic hepatitis, NASH, Wilson disease, and cholestatic conditions. Triglyceride droplets form macro- or microvesicular steatosis. Alpha-1-antitrypsin deficiency produces PAS-positive diastase-resistant globules in periportal hepatocytes (retained misfolded ATZ polymer in ER). HBsAg accumulation causes 'ground glass' hepatocytes.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.