Ballooning Degeneration Pathology Outlines. The injury may be seen in the form of hepatocyte ballooning, n

The injury may be seen in the form of hepatocyte ballooning, neutrophil rich inflammation in the lobular parenchyma (Figure 1), apoptosis or Mallory Denk bodies. In pathology, a Councilman body, also known as a Councilman hyaline body or apoptotic body, is an eosinophilic globule of apoptotic hepatocyte cell fragments. Hepatocellular ballooning is a common finding in chronic liver disease, mainly characterized by rarefied cytoplasm that often contains Mallory-Denk bodies (MDB). 861 and 0. Viral hepatitis A rarely leads to signficant necrosis, but hepatitis B can result in a fulminant hepatitis with extensive necrosis. Ballooning Degeneration There is a discrete bleb (vacuole) of fluid within the cytoplasm. Mar 13, 2025 · Oral hairy leukoplakia: EBER is positive in the spinous cell layer Parakeratosis and ballooning degeneration of the spinous keratinocytes Margination of chromatin (i. Jul 26, 2024 · Ballooning degeneration is seen as more severe degrees of cell swelling Acidophil bodies or Councilman bodies Eosinophilic globule or fragments of apoptotic hepatocytes where deposits of HBsAg are found (Leber Magen Darm 1982;12:146) Granular or vacuolated cytoplasm might be present Nov 23, 2021 · Liver & intrahepatic bile ducts - Diagnostic patterns - differential diagnosis - Identification of histologic features that define different patterns of liver injury to formulate appropriate differential diagnoses The classic histopathological findings of herpetic infection are well established (acantholysis, ballooning degeneration, intranuclear inclusions, multinucleation, necrosis, and formation of vesicles or ulcers). Jun 12, 2025 · The Bethesda System for Reporting Thyroid Cytopathology (TBS) is an international reporting system for thyroid cytology. Dec 10, 2024 · Primary malignancy of liver with hepatocellular differentiation Dec 1, 2008 · Subsequent studies further strengthened the notion that hepatocytic ballooning is not only a unique morphological change reflecting liver cell injury in NASH, but it is also a distinctive histological feature that experienced liver pathologists commonly use to arrive at a diagnosis of SH. In reticular degeneration, there is hydropic swelling and rupture of the intercellular adhesions. Dec 31, 2025 · The autopsy pathologist (gross image shown above) notes severe medial degeneration when examining a section of the suprarenal aorta. Sep 14, 2011 · We would like to show you a description here but the site won’t allow us. . Balloon cells are altered melanocytes with clear vacuolated cytoplasm caused by a defect in the process of melanogenesis. , the so called ‘ballooning’ process. Jul 15, 2021 · Clear cell variant of hepatocellular carcinoma: Tumor cells contain glycogen, may contain some fat Will not show inflammatory features, such as ballooning degeneration of hepatocytes or Mallory-Denk bodies Benign liver with steatohepatitis: Lacks features of malignancy, such as increased N/C ratio, thickened trabeculae, unpaired arteries Hepatocyte “ballooning” is an often used but ill defined term in liver pathology to designate a special form of liver cell degeneration associated with cell swelling and enlargement found particularly in steatohepatitis. Bilirubinostasis may be present in late biliary type cirrhosis but is not associated with periseptal halo (answer B). In ballooning degeneration, keratinocytes appear swollen, pale, and round due to intracellular edema and loss of intercellular bridges. png, H&E stain. Neutrophilic infiltrates and steatosis are also seen. In contrast, human embryonic hair follicles tend to employ phagocytosis as a self-destructive mechanism [13]. Feb 1, 2014 · Definition / general Age related (senile) macular degeneration is the most common cause of irreversible visual loss in US Causes loss of central portion of vision May be due to vascular disease in choriocapillaris and retinal pigment epithelium We would like to show you a description here but the site won’t allow us. The histological sections of liver tissue stained by the H&E method were analyzed with a conventional light microscope, with emphasis on the detection of deposits and lipid degeneration of hepatocytes, ballooning, distribution and morphological location. Grading of Disease Activity in Nonalcoholic Steatohepatitis Staging of Nonalcoholic Steatohepatitis Corticobasal degeneration (CBD) is a rare, progressive neurodegenerative disorder characterized by a 4 repeat tau isoform tauopathy Other causes Ballooning hepatocytes may also be seen in autoimmune hepatitis, exposure to certain toxins, or other conditions that stress and injure the liver. Jul 26, 2024 · Ballooning degeneration is seen as more severe degrees of cell swelling Acidophil bodies or Councilman bodies Eosinophilic globule or fragments of apoptotic hepatocytes where deposits of HBsAg are found (Leber Magen Darm 1982;12:146) Granular or vacuolated cytoplasm might be present Jun 7, 2021 · Ballooning degeneration is a hallmark pathological change of steatohepatitis, which is not associated with biliary type cirrhosis (answer A). Abstract Background/aims: Hepatocyte "ballooning" is an often used but ill defined term in liver pathology to designate a special form of liver cell degeneration associated with cell swelling and enlargement found particularly in steatohepatitis. [1] Ballooning degeneration is a histomorphologic change seen in liver pathology. [1] Cells undergoing this form of cell death have a flocculant appearing cytoplasm, [2] and are larger than Balloon cell melanoma (BCM) is a rare variant of melanoma in which the tumor cells have abundant clear or eosinophilic granular cytoplasm causing ballooning of cells. 2 It is observed in virus disorders affecting epithelia, such as herpesvirus, monkeypox, orf and hand-foot-and-mouth disease. [1] Micrograph showing cholestasis, as is apparent by the yellow bile. 852, respectively. At a later stage, a dying hepatocyte is seen shrinking down to form an eosinophilic Ballooning degeneration: In ballooning degeneration, keratinocytes appear swollen, pale and round due to intra-cellular oedema and loss of intercellular bridges. H&E stain. the herpes simplex vesicle. Jul 15, 2021 · Clear cell variant of hepatocellular carcinoma: Tumor cells contain glycogen, may contain some fat Will not show inflammatory features, such as ballooning degeneration of hepatocytes or Mallory-Denk bodies Benign liver with steatohepatitis: Lacks features of malignancy, such as increased N/C ratio, thickened trabeculae, unpaired arteries Ballooning degeneration is a histomorphologic change seen in liver pathology. In histo pathology, feathery degeneration, formally feathery degeneration of hepatocytes, is a form of liver parenchymal cell (i. Note: Pathweb Study Notes are based on the key topics covered in the lectures in the Yong Loo Lin School of Medicine, as well as additional topics covered in major texts. Herpes infection can also cause histopathological changes in many dermal structures. Dec 10, 2024 · Primary malignancy of liver with hepatocellular differentiation Ballooning degeneration of hepatocytes (Click on image for an enlarged view – Image by Nephron) Type of hepatocyte death Form of apoptosis Seen in hepatocytes infected with certain viruses characterised by increase in cell size (ballooning) with wispy/cobweb like cytoplasm, cytoplasmic vacuolation, pyknotic nucleus Feathery degeneration - large cells with pale flocculant cytoplasm (left-bottom and right-top). An example of ballooning degeneration is found in viral vesicles, e. There are two types of hydropic degeneration, in which: The cells may swell up like a balloon prior to their destruction. After certification, many anatomic pathologists specialize further in practice. Histopathology of a ballooning hepatocyte. Balloon cell melanoma (BCM) is a rare variant of melanoma in which the tumor cells have abundant clear or eosinophilic granular cytoplasm causing ballooning of cells. In m<massive intracellular edema the cell body is inflated like a balloon and bursts. Reticulin shows two cell thick cords (green arrows) of regeneration. In pemphigus foliaceus, there is acantholysis of keratinocytes just below the granular layer of the epidermis. Is a more severe or advanced form of cellular swelling. Ballooning degeneration is a histopathological term describing the swelling and rounding of hepatocytes in the liver, representing an early stage of cellular injury that progresses toward necrosis, characterized by cellular enlargement, vacuolization, and disruption of the cytoskeleton. Jun 14, 2021 · Pathophysiologically, ballooning is a result of severe cell injury, depletion of adenosine triphosphate (ATP) and rise in intracellular calcium, leading to loss of plasma membrane volume control and disruption of the hepatocyte intermediate filament network A 40-year-old female with a past medical history significant for obesity (BMI 36), hypertension, hyperlipidemia, and type II diabetes mellitus, presents for evaluation due to elevated AST and ALT. The balloon cell naevus is characterized by large, vacuolated nevus cells with clear cytoplasm and central nucleus. C. 8, 24 In a clinicopathological correlative study based Jan 30, 2023 · Common terms & patterns: this topic represents an overview of common terms and microscopic findings of the most frequently seen reaction pattern in dermatopathology The swollen hepatocytes have reduced or absent cytokeratin 8/18 filaments, as demonstrated by CK8/18 immunostains; this feature is notably absent in non-steatohepatitic ballooning degeneration, such as that seen in viral hepatitis. Hydropic degeneration often indicates severe cellular damage due to viruses. , nuclear beading) of the spinous keratinocytes is observed; koilocytosis may also be noted Both phenomena are cytopathic effects of an Epstein-Barr virus infection The compendium (Part 2) – B – BALLOON MELANOCYTE: an abnormally large melanocyte that has abundant, clear cytoplasm and a normal nucleus. This study demonstrates the novel use of SHG technology in the automated image detection of balloon cells. g. However, such proliferation seems to be a self-regulatory process – where unlimited production of melanosomes continues without accompanying melanization until degeneration of the melanosome i. Cholestatic hepatitis and feathery degeneration redirect to this article. The ballooned appearance of these cells is due to abnormal melanosome development. A large pink cell undergoing "ballooning degeneration" is seen below the right arrow. A Councilman body can also be seen in the upper-right of the section. Such cells formed secondary to degenerative changes may lead to an interpretation of ‘atypical’ cells. hepatocyte) death. These large nuclei, however, usually have fine powdery chromatin with evenly distributed small nucleoli. Apr 21, 2025 · MASLD is hepatic steatosis associated with obesity, type 2 diabetes mellitus, etc. (WC) Ballooning degeneration is a histomorphologic change seen in liver pathology. Apr 13, 2023 · Etiology Old age is the most common cause of degenerative valve disease Early occurrence of degeneration can occur if the patient has a prior valve disease (Int J Stroke 2018;13:612) Jun 7, 2021 · Ballooning degeneration is a hallmark pathological change of steatohepatitis, which is not associated with biliary type cirrhosis (answer A). [1] Ballooning degeneration is characterized by intense cytoplasmic eosinophilia of the keratinocytes with loss of intracellular cohesion resulting in acantholysis. Ballooning degeneration centre-left and centre-right. hepatocyte) death associated with cholestasis. [1] May 1, 2012 · Periportal inflammation and necrosis, ballooning degeneration, apoptosis Cholestasis and increased portal and periportal plasma cells are relatively specific for hepatitis A Acidophil bodies or cytolysis are present (collapse of reticulin network where cells have disappeared with appearance of macrophage aggregates) See also Ballooning degeneration – another histopathologic finding of steatohepatitis Councilman body (upper-right) and ballooning degeneration (centre-left). 3 It is the result of cytopathic efect of virus on keratinocytes. Foamy macrophage-like hepatocytes (blue arrows) show feathery degeneration is also present. Degeneration may also lead to fusion of nuclear membranes, with the formation of a mesothelial cell with one or more gigantic nuclei. [1] Jan 1, 2013 · Microscopic (histologic) description Annular fibrosus: collagen (pink) Nucleus pulposus: pure cartilage (blue) Herniated disk: vascular ingrowth Also chondrocyte proliferation, structural alterations in form of tears and clefts, granular changes and mucous degeneration (BMC Res Notes 2011;4:497) Which may be accompanied by mild septal and portal chronic inflammation, lobular cholestasis with or without mild lobular inflammation, steatosis, ballooning degeneration, Mallory bodies, giant cell transformation, and granular reddish-brown deposits in periseptal hepatocytes. What specific change is most likely to also be seen in this tissue sample? Balloon cell degeneration of keratinocytes. Ballooning degeneration is a histomorphologic change seen in liver pathology. Nov 3, 2025 · Liver biopsy remains a critical diagnostic and prognostic tool in hepatology, despite advancements in noninvasive techniques Oct 29, 2020 · Intracellular edema with paranuclear vacuoles. BALLOONING: “intracellular edema” of epidermis and epithelial structures of adnexa, recognizably morphologically as swollen pale cytoplasm of affected spinous cells Histopathological features that indicate hepatocellular injury in NASH include ballooning degeneration, lobular inflammation, and apoptotic bodies. In herpes virus infection, afected cells Aug 18, 2022 · Ballooning degeneration is a more severe swelling characterized by rarified cytoplasm and occasional Mallory hyaline Drug reactions, autoimmune hepatitis, acute alcoholic hepatitis, Wilson disease Neutrophilic satellitosis: neutrophils surrounding ballooned hepatocytes with Mallory hyaline and is seen in active cases of alcoholic steatohepatitis Histopathological features that indicate hepatocellular injury in NASH include ballooning degeneration, lobular inflammation, and apoptotic bodies. Histopathology of LSD: H&E. Lab Test Results In histo pathology, ballooning degeneration, formally ballooning degeneration of hepatocytes, is a form of liver parenchymal cell (i. Ballooning degeneration is Micrograph showing a Mallory body with the characteristic twisted-rope appearance (centre of image - within a ballooning hepatocyte). Apr 13, 2023 · Etiology Old age is the most common cause of degenerative valve disease Early occurrence of degeneration can occur if the patient has a prior valve disease (Int J Stroke 2018;13:612) B. Ballooning degeneration can be induced by exposure to certain substances, such as AgNPs, which can alter intracellular homeostasis and induce autophagosome formation. Mar 17, 2022 · Steatosis with inflammation and ballooning degeneration, which is the hallmark of hepatocellular injury in steatohepatitis Ballooning degeneration is characterized by cellular swelling, rarefaction of the hepatocytic cytoplasm and clumped strands of intermediate filaments Satellitosis is featured by ballooned hepatocyte surrounded by neutrophils Apr 5, 2023 · Ballooning degeneration is not specifically defined in the histological non-alcoholic fatty liver disease (NAFLD) activity score (NAS) proposed by the NASH Clinical Research Network (NASH-CRN), nor there is guidance for scoring severity of hepatocytic ballooning beyond the generic descriptors ‘few’ or ‘many’. This degeneration is most prominently associated with steatohepatitis, including metabolic dysfunction Microscopic finding (HE stain, high power view): Hepatocytes show ballooning degeneration and most of the cells contain cytoplasmic eosinophilic Mallory bodies (red arrows). This leads to separation of the epithelial cells with swelling of the epithelial cells (‘ballooning degeneration’). Hepatocellular plate architecture is distorted. Basal cell carcinoma arises from the interfollicular or follicular epithelium and is the most common malignant tumor type in humans Learn about hepatocyte ballooning, its causes, significance in liver pathology, and how it differs from steatosis. Area under receiver operating characteristic (AUROC) anal-ysis for prediction of ballooning degeneration scores 1 and 2 were 0. May 1, 2008 · Background/Aims Hepatocyte “ballooning” is an often used but ill defined term in liver pathology to designate a special form of liver cell degeneration associated with cell swelling and enlargement found particularly in steatohepatitis. In histopathology, a Mallory body, Mallory–Denk body (MDB), or Mallory's hyaline is an inclusion found in the cytoplasm of liver cells. 5 – 2 times the normal diameter with loss of the usual polygonal shape of the cell and usually containing pale staining cytoplasm, variably sized cytoplasmic vacuoles, and frequently Mallory Denk bodies. The most recent liver enzymes and antibody results are seen below. The presence of ballooned hepatocytes, along with necro-inflammatory activity, enables a diagnosis of steatohepatitis. Hydropic cell swelling represents an osmotic cell edema due to impaired hepatocellular energy homeo-stasis and altered permeability of the cell membrane; these alterations affect ion pumps localized in the Acantholysis occurs due to failure of the integrity of the intercellular / intraepidermal cell junctions. Why are ballooning hepatocytes important in a pathology report? When ballooning hepatocytes are described in a pathology report, it tells your doctor that the liver cells are being damaged. Hepatocellular ballooning is a key feature required for the diagnosis of NASH and a component of currently used histological grading and staging systems of NAFLD. Hydropic degeneration on the epidermis (arrow) and edema on the Ballooning degeneration is observed in viral, toxic (alcohol), and ischemic liver damage, mainly in centrilobular (zone 3) hepatocytes. D. e. Apr 5, 2023 · Ballooning degeneration is not specifically defined in the histological non-alcoholic fatty liver disease (NAFLD) activity score (NAS) proposed by the NASH Clinical Research Network (NASH-CRN), nor there is guidance for scoring severity of hepatocytic ballooning beyond the generic descriptors ‘few’ or ‘many’. Scoring schemes, such as the NASH Clinical Research Network (CRN), use those histopathological features to grade the severity of the disease and determine a stage based on the amount of fibrosis. (WC) In liver pathology, cholestasis is a stoppage or abnormally slow flow of bile. Nov 8, 2021 · High level of wall motion abnormality Large area of ballooning relative to troponin levels suggests stretch and nonapoptotic myocardial injury (Heart 2018;104:96) Localization to ventricular myocardium may be related to apical - basal gradient of sympathetic innervation and beta adrenergic receptor density (Eur Heart J 2018;39:2032) Jul 26, 2023 · In the lobule, mild mixed predominantly small droplet macrovesicular steatosis involving less than 5% of hepatocytes is noted but without evident signs of steatohepatitis (lobular inflammation, hepatocyte ballooning degeneration, Mallory-Denk bodies, megamitochondria, or apoptotic bodies). This ballooning degeneration may be seen in a variety of conditions, but is most closely associated with fatty liver disease. Steatohepatitis indicates evidence of hepatic injury accompanying the steatosis. Vacuolar Degeneration Ballooning Degeneration May We would like to show you a description here but the site won’t allow us. 2 It is observed in virus disorders afecting epithelia, such as herpesvirus, monkeypox, orf and hand-foot-and-mouth disease. 3 It is the result of cytopathic effect of virus on keratinocytes. We would like to show you a description here but the site won’t allow us. Tufts (green arrows) prove ballooning degeneration needed for a diagnosis of steatohepatitis. Trichrome shows blue bands and definite nodules (white arrows). [1] Mallory bodies are damaged intermediate filaments within the liver cells. Alterations of the intermediate filament cytoskeleton of the hepatocyte may contribute to the pathogenesis of this microscopic change. Area under receiver operating characteristic (AUROC) analysis for prediction of ballooning degeneration scores 1 and 2 were 0. It is often observed in conjunction with other forms of liver degeneration, such as lobular degeneration and giant cell transformation. Jun 7, 2021 · Ballooning degeneration is a hallmark pathological change of steatohepatitis, which is not associated with biliary type cirrhosis (answer A). For more comprehensive discussion on specific pathology topics, readers are advised to refer to the recommended texts in your respective courses. The patient denies drug and alcohol use. Although there is overlap between anatomic and clinical pathology, the focus of this book is anatomic pathology; clinical pathology is taught separately in most veterinary curricula. Ballooning degeneration (arrow) and intracytoplasmic eosinophilic inclusion bodies (arrowhead) 100 X (a). Ultimately, the fragments are taken up by macrophages or adjacent parenchymal cells. In ballooning degeneration, keratinocytes appear swollen, pale and round due to intracellular oedema and loss of intercellular bridges. The name is derived from the fact that the cells undergoing this form of cell death increase in size (balloon). Explore the cellular mechanisms We would like to show you a description here but the site won’t allow us. This leads to the formation of intraepidermal multilocular vesicles. ; MASH is an aggressive form of MASLD characterized by marked inflammatory damage and hepatocyte ballooning. Ballooning degeneration of hepatocytes is the predominant mode of cellular injury in alcoholic hepatitis. Ballooning has mostly been attributed to degeneration but its striking resemblance to Ballooning degeneration Ballooning degeneration. The classic histopathological findings of herpetic infection are well established (acantholysis, ballooning degeneration, intranuclear inclusions, multinucleation, necrosis, and formation of vesicles or ulcers). Mar 1, 2017 · Hepatocellular ballooning or ‘balloon degeneration’ in NASH is defined as rounded hepatocyte enlargement > 1. It is indicative of steatohepatitis. Microscopic finding (HE stain, high power view): Hepatocytes show ballooning degeneration and most of the cells contain cytoplasmic eosinophilic Mallory bodies (red arrows). In histopathology, ballooning degeneration, formally ballooning degeneration of hepatocytes, is a form of liver parenchymal cell (i. In histo pathology, ballooning degeneration, formally ballooning degeneration of hepatocytes, is a form of liver parenchymal cell (i. [1] Balloon cell melanoma (BCM) is a rare variant of melanoma in which the tumor cells have abundant clear or eosinophilic granular cytoplasm causing ballooning of cells. pathology, medical education, student Individual hepatocytes are affected by viral hepatitis.

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