Hemodynamic disorders · USMLE Step 1

In chronic passive congestion of the liver (e.g., right-sided heart failure), what is the classic gross appearance often described by pathologists?

  1. Cirrhosis with a micronodular surface
  2. Nutmeg liver with mottled centrilobular zones
  3. Fatty liver with pale, enlarged hepatocytes
  4. Massive hemorrhagic necrosis of the parenchyma
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Correct answer: Nutmeg liver with mottled centrilobular zones

Chronic passive congestion causes centrilobular congestion and hemorrhage; on gross exam the liver shows mottled red-brown centrilobular zones against tan lobular tissue — the so-called “nutmeg liver.”

Difficulty: Medium Question 13 of 19

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