A 48-year-old man with alcohol use disorder has liver biopsy showing Mallory-Denk bodies, neutrophilic infiltrate, and ballooning hepatocyte degeneration. Mallory-Denk bodies are composed of:
- A Aggregates of abnormal alpha-1 antitrypsin protein in the ER
- B Ubiquitinated intermediate filaments (cytokeratin 8 and 18) forming hepatocyte inclusions ✓
- C Lipofuscin granules from lipid peroxidation products
- D Accumulated glycogen in hepatocyte nuclei
Explanation
Mallory-Denk bodies (previously called Mallory bodies or alcoholic hyalin) are pathological inclusions composed of ubiquitinated aggregates of cytokeratin 8 and 18 (intermediate filaments) combined with p62 (sequestosome) and heat shock proteins, forming irregular pink eosinophilic clumps in hepatocyte cytoplasm. They are not exclusive to alcoholic hepatitis and occur in NASH, PBC, Wilson's disease, and drug-induced liver injury, but are most classic in alcoholic hepatitis. Alpha-1 antitrypsin globules (PAS-diastase positive) are different inclusions. Lipofuscin is a wear-and-tear pigment.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.