Ballooning degeneration
Encyclopedia
In histo
pathology
, ballooning degeneration, formally ballooning degeneration of hepatocytes, is a form of liver
parenchyma
l cell
(i.e. hepatocyte
) death
.
The name is derived from the fact that the cells undergoing this form of cell death increase in size (balloon
).
It is generally regarded to be a form of apoptosis
, and is a descriptor used in the context of inflamed
fatty liver
(steatohepatitis
), which may be due to obesity
or alcohol
.
The histomorphological appearance of ballooning degeneration is not pathognomonic
for steatohepatitis, but usage of the term is generally confined to the condition, i.e. in the context of other histopathological findings the label ballooning degeneration is not used for cell death with cytoplasmic clearing and cell swelling.
on H&E stain
ed sections. They can be differentiated from adipocyte
-like cells by their cytoplasm and nucleus; ballooned cells have their nucleus in the centre (unlike adipocyte-like cells which have it peripherally). Also, ballooned cells have (small) pyknotic nuclei or nuclei that are undergoing karyorrhexis
, i.e. in the process of disintegrating. The cytoplasm of cells undergoing ballooning degeneration is wispy/cobweb-like, while adipocyte
-like cells have a clear cytoplasm or a vacuolated
one.
, which is associated with cholestasis
, and also has cytoplasmic clearing and cell swelling.
Histology
Histology is the study of the microscopic anatomy of cells and tissues of plants and animals. It is performed by examining cells and tissues commonly by sectioning and staining; followed by examination under a light microscope or electron microscope...
pathology
Pathology
Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....
, ballooning degeneration, formally ballooning degeneration of hepatocytes, is a form of liver
Liver
The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...
parenchyma
Parenchyma
Parenchyma is a term used to describe a bulk of a substance. It is used in different ways in animals and in plants.The term is New Latin, f. Greek παρέγχυμα - parenkhuma, "visceral flesh", f. παρεγχεῖν - parenkhein, "to pour in" f. para-, "beside" + en-, "in" + khein, "to pour"...
l cell
Cell (biology)
The cell is the basic structural and functional unit of all known living organisms. It is the smallest unit of life that is classified as a living thing, and is often called the building block of life. The Alberts text discusses how the "cellular building blocks" move to shape developing embryos....
(i.e. hepatocyte
Hepatocyte
A hepatocyte is a cell of the main tissue of the liver. Hepatocytes make up 70-80% of the liver's cytoplasmic mass.These cells are involved in:* Protein synthesis* Protein storage* Transformation of carbohydrates...
) death
Death
Death is the permanent termination of the biological functions that sustain a living organism. Phenomena which commonly bring about death include old age, predation, malnutrition, disease, and accidents or trauma resulting in terminal injury....
.
The name is derived from the fact that the cells undergoing this form of cell death increase in size (balloon
Balloon
A balloon is an inflatable flexible bag filled with a gas, such as helium, hydrogen, nitrous oxide, oxygen, or air. Modern balloons can be made from materials such as rubber, latex, polychloroprene, or a nylon fabric, while some early balloons were made of dried animal bladders, such as the pig...
).
It is generally regarded to be a form of apoptosis
Apoptosis
Apoptosis is the process of programmed cell death that may occur in multicellular organisms. Biochemical events lead to characteristic cell changes and death. These changes include blebbing, cell shrinkage, nuclear fragmentation, chromatin condensation, and chromosomal DNA fragmentation...
, and is a descriptor used in the context of inflamed
Inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...
fatty liver
Fatty liver
Fatty liver, also known as fatty liver disease , is a reversible condition where large vacuoles of triglyceride fat accumulate in liver cells via the process of steatosis...
(steatohepatitis
Steatohepatitis
Steatohepatitis is a type of liver disease, characterized by inflammation of the liver with concurrent fat accumulation in liver...
), which may be due to obesity
Obesity
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems...
or alcohol
Alcohol
In chemistry, an alcohol is an organic compound in which the hydroxy functional group is bound to a carbon atom. In particular, this carbon center should be saturated, having single bonds to three other atoms....
.
The histomorphological appearance of ballooning degeneration is not pathognomonic
Pathognomonic
Pathognomonic is a term, often used in medicine, that means characteristic for a particular disease. A pathognomonic sign is a particular sign whose presence means that a particular disease is present beyond any doubt...
for steatohepatitis, but usage of the term is generally confined to the condition, i.e. in the context of other histopathological findings the label ballooning degeneration is not used for cell death with cytoplasmic clearing and cell swelling.
Appearance
Ballooned cells are typically two to three times the size of adjacent hepatocytes and are characterized by a whispy cleared cytoplasmCytoplasm
The cytoplasm is a small gel-like substance residing between the cell membrane holding all the cell's internal sub-structures , except for the nucleus. All the contents of the cells of prokaryote organisms are contained within the cytoplasm...
on H&E stain
H&E stain
H&E stain, HE stain or hematoxylin and eosin stain is a popular staining method in histology. It is the most widely used stain in medical diagnosis; for example when a pathologist looks at a biopsy of a suspected cancer, the histological section is likely to be stained with H&E and termed H&E...
ed sections. They can be differentiated from adipocyte
Adipocyte
However, in some reports and textbooks, the number of fat cell increased in childhood and adolescence. The total number is constant in both obese and lean adult...
-like cells by their cytoplasm and nucleus; ballooned cells have their nucleus in the centre (unlike adipocyte-like cells which have it peripherally). Also, ballooned cells have (small) pyknotic nuclei or nuclei that are undergoing karyorrhexis
Karyorrhexis
Karyorrhexis is the destructive fragmentation of the nucleus of a dying cell whereby its chromatin is distributed irregularly throughout the cytoplasm. It is usually preceded by pyknosis and is followed by karyolysis and can occur as a result of either programmed cell death or necrosis....
, i.e. in the process of disintegrating. The cytoplasm of cells undergoing ballooning degeneration is wispy/cobweb-like, while adipocyte
Adipocyte
However, in some reports and textbooks, the number of fat cell increased in childhood and adolescence. The total number is constant in both obese and lean adult...
-like cells have a clear cytoplasm or a vacuolated
Vacuole
A vacuole is a membrane-bound organelle which is present in all plant and fungal cells and some protist, animal and bacterial cells. Vacuoles are essentially enclosed compartments which are filled with water containing inorganic and organic molecules including enzymes in solution, though in certain...
one.
Relation to feathery degeneration
Ballooning degeneration is somewhat similar in appearance to feathery degenerationFeathery degeneration
In histopathology, feathery degeneration, formally feathery degeneration of hepatocytes, is a form of liver parenchymal cell death associated with cholestasis....
, which is associated with cholestasis
Cholestasis
In medicine, cholestasis is a condition where bile cannot flow from the liver to the duodenum. The two basic distinctions are an obstructive type of cholestasis where there is a mechanical blockage in the duct system such as can occur from a gallstone or malignancy and metabolic types of...
, and also has cytoplasmic clearing and cell swelling.
See also
- Councilman bodyCouncilman bodyIn pathology, a Councilman body, also known as Councilman hyaline body, is an eosinophilic globule often found in the liver of individuals suffering from viral hepatitis, yellow fever, or other viral syndrome...
- Ground glass hepatocyteGround glass hepatocyteIn liver pathology, a ground glass hepatocyte, abbreviated GGH, is a liver parenchymal cell with a flat hazy and uniformly dull appearing cytoplasm on light microscopy...
- Mallory bodyMallory bodyIn histopathology, a Mallory body, Mallory-Denk body, and Mallory's hyaline, is an inclusion found in the cytoplasm of liver cells.-Associated conditions:...
- Non-alcoholic fatty liver diseaseNon-alcoholic fatty liver diseaseNon-alcoholic fatty liver disease is one cause of a fatty liver, occurring when fat is deposited in the liver not due to excessive alcohol use. It is related to insulin resistance and the metabolic syndrome and may respond to treatments originally developed for other insulin-resistant states...
External links
- Ballooning degeneration and feathery degeneration - what is the difference? - a T-shirt that asks the question - zcache.com.
