A 45-year-old alcoholic man has tender hepatomegaly. Liver biopsy shows hepatocyte ballooning, Mallory-Denk bodies, neutrophilic infiltration, and pericellular ('chicken-wire') fibrosis. Mallory-Denk bodies are composed of:
- A Aggregated alpha-1 antitrypsin globules
- B Ubiquitinated intermediate filament proteins (cytokeratins 8 and 18) ✓
- C Iron-laden ferritin aggregates
- D Fibrin within hepatocyte cytoplasm
Correct answer: B. Ubiquitinated intermediate filament proteins (cytokeratins 8 and 18)
Explanation
Mallory-Denk bodies (formerly Mallory bodies) are intracytoplasmic eosinophilic inclusions in damaged hepatocytes composed of misfolded, ubiquitinated intermediate filaments — specifically cytokeratin 8 and 18 along with p62, ubiquitin, and heat shock proteins. They are characteristic of alcoholic hepatitis but also occur in NASH, cholestasis, and Wilson's disease. Alpha-1 antitrypsin globules are PAS-positive diastase-resistant globules in alpha-1 AT deficiency.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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