In alcoholic liver disease, the sequence of morphological changes in the correct order from earliest to most advanced is:

• A Cirrhosis → alcoholic hepatitis → steatosis
• B Alcoholic hepatitis → steatosis → cirrhosis
• C Steatosis → alcoholic hepatitis → cirrhosis ✓
• D Steatosis → cirrhosis → alcoholic hepatitis

Explanation

Alcoholic liver disease progresses from steatosis (fatty change, reversible) → alcoholic hepatitis (steatosis + hepatocyte ballooning, Mallory-Denk bodies, neutrophil infiltrate) → cirrhosis (irreversible fibrosis with nodule formation). Not all patients progress through each stage; steatosis is nearly universal, but only 10–35% develop hepatitis and a smaller proportion develop cirrhosis.

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

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Written and medically reviewed by the StethoPrep medical team.