In alcoholic liver disease, the histological triad of steatohepatitis includes fatty change, hepatocyte ballooning, and which characteristic cytoplasmic inclusion?

• A Mallory-Denk bodies (eosinophilic cytoplasmic aggregates of ubiquitinated keratin 8/18) ✓
• B Councilman bodies (acidophilic apoptotic remnants)
• C Ground-glass inclusions (HBsAg aggregates)
• D Lafora bodies (polyglucosan inclusions)

Explanation

Mallory-Denk bodies are the characteristic pathological finding in alcoholic hepatitis, consisting of irregular eosinophilic perinuclear cytoplasmic aggregates composed of ubiquitinated intermediate filaments (keratin 8 and 18) along with p62 and heat shock proteins. They reflect impaired proteasomal degradation of misfolded cytoskeletal proteins caused by oxidative stress and acetaldehyde. Councilman bodies are apoptotic hepatocyte remnants seen in viral hepatitis. Ground-glass inclusions represent HBsAg accumulation in chronic hepatitis B. Lafora bodies occur in Lafora disease (progressive myoclonic epilepsy).

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

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