Systemic Pathology by Organ · USMLE Step 1

In chronic passive congestion of the liver due to right-sided heart failure, what gross feature is most likely observed?

  1. Nodular cirrhosis throughout the liver
  2. Nutmeg appearance with centrilobular congestion
  3. Extensive fat infiltration (steatosis)
  4. Peliosis hepatis with blood-filled cavities
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Correct answer: Nutmeg appearance with centrilobular congestion

Chronic right-sided heart failure causes congestion of hepatic venous outflow, leading to centrilobular (zone 3) congestion and hemorrhage producing the classic nutmeg liver appearance. (Systemic pathology references)

Difficulty: Medium Question 2 of 19

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