clearly evident zonal necrosis in the centrilobular region Image

necrosis of hepatocytes around central vein Image

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cells on the way out Image

different case of a core biopsy Image

trichrome is quite nice to show Image

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Acetominophen -- dose-related hepatotoxin that can cause fulminant liver failure when taken in massive overdoses or, much less commonly, at therapeutic doses in susceptible individuals. Fasting individuals or those who also consume alchohol are at risk. Injury is due to formation of the toxic metabolite N-acetyl-p-benzoquinine imine generated through the cytochrome P-450 drug-metabolizing system. Normally, hepatic stores of glutathione combine with the toxic metabolite and prevent liver cell injury. When glutathione stores are depleted by this metabolite, the metabolite binds to liver cell proteins and results hepatic necrosis.