A 50-year-old man with chronic alcoholism has liver biopsy showing hepatocyte ballooning, Mallory-Denk bodies, neutrophilic infiltration, and centrilobular fibrosis. Which cytoskeletal proteins aggregate to form Mallory-Denk bodies?

• A Desmin and vimentin intermediate filaments
• B Actin microfilaments and alpha-tubulin
• C Ubiquitin-bound alpha-smooth muscle actin
• D Keratin 8 and keratin 18 intermediate filaments ✓

Explanation

Mallory-Denk bodies (Mallory hyaline) are intracytoplasmic inclusions in ballooned hepatocytes consisting of aggregated keratin 8 and keratin 18 intermediate filaments, along with ubiquitin and p62/sequestosome-1. They reflect impaired protein degradation and cytoskeletal injury in alcoholic steatohepatitis and also occur in NASH, PBC, and cholestatic liver disease. Desmin/vimentin are intermediate filaments of muscle/mesenchymal cells, not hepatocytes.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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