Ultrastructural findings in human nonalcoholic steatohepatitis

Ultrastructural examination of the hepatocyte in disease states has been an important research tool for many years [1]. Although eclipsed by techniques of molecular biology, electron microscopy (EM) remains a useful and insightful tool. EM can inform various aspects of fat metabolism in fatty liver disease, including alcoholic fatty liver, nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). Limitations of EM include small sample size, artifact introduced by variations in the technique of sample processing, laborintensive methods and a paucity of normal tissue controls in human studies [2]. However, refinements in technique and technology have evolved into reliable methodology, and EM offers an intriguing perspective on cellular physiology. In this article, we highlight key observations reported in human NASH, along with potential pathophysiologic correlations.