Slide 24.Cardiac congestion, Liver

A. Brief Descriptions

  1. Chronic passive congestion of the liver ; so-called nutmeg liver.

  2. Cause: Right –side heart failure , chronic passive congestion of the liver.

B. Gross Findings

  1. Dark congested & hemorrhagic perivenular areas with paler zone 2 areas (yellowish tinge due to fatty change) & pale periportal areas.

C. Micro Findings

  1. Congestive changes and accentuation of the centrilobular areas surrounded by paler hypoxic regions.

  2. In severe form: central lobular necrosis appear along with sinusoidal congestion with persistence, it become sclerotic → cardiac cirrhosis.

D. Others:


E. Reference

  1. Robbins Pathologic Basis of Disease, 6th ed.  P.116-117.




Fig. 24-1 (LP)Destruction of regular liver structure especially in the central areas (perivenular areas).



Fig. 24-2 (LP)Sinusoidal congestion and necrosis of hepatocytes in the perivenular areas; note the portal area (right low) is not affected.



Fig. 24-3 (LP)Necrosis of perivenular hepatocytes.



Fig. 24- (HP)Necrosis of perivenular hepatocytes.