WordNet

the process of declining from a higher to a lower level of effective power or vitality or essential quality (同)devolution
passing from a more complex to a simpler biological form (同)retrogression
flying in a balloon

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退歩,退化,墜落
気球操縦競技

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/03/08 10:55:09」(JST)

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Ballooning degeneration centre-left and centre-right. H&E stain.

In histopathology, ballooning degeneration, formally ballooning degeneration of hepatocytes, is a form of liver parenchymal cell (i.e. hepatocyte) death.

The name is derived from the fact that the cells undergoing this form of cell death increase in size (balloon).

It is generally considered a form of apoptosis,^[1] and is a descriptor used in the context of inflamed fatty liver (steatohepatitis),^[2] which may be due to obesity or alcohol.

The histomorphological appearance of ballooning degeneration is not pathognomonic for steatohepatitis, but usage of the term is generally confined to the condition, i.e. in the context of other histopathological findings the label ballooning degeneration is not used for cell death with cytoplasmic clearing and cell swelling.

Appearance

Ballooned cells are typically two to three times the size of adjacent hepatocytes and are characterized by a wispy cleared cytoplasm on H&E stained sections. They can be differentiated from adipocyte-like cells by their cytoplasm and nucleus; ballooned cells have their nucleus in the centre (unlike adipocyte-like cells, which have it peripherally). Also, ballooned cells have (small) pyknotic nuclei or nuclei that are undergoing karyorrhexis, i.e. in the process of disintegrating. The cytoplasm of cells undergoing ballooning degeneration is wispy/cobweb-like, while adipocyte-like cells have a clear cytoplasm or a vacuolated one.

Relation to feathery degeneration

Ballooning degeneration is somewhat similar in appearance to feathery degeneration, which is associated with cholestasis, and also has cytoplasmic clearing and cell swelling.

Additional images

Ballooning degeneration. H&E stain.

References

^ Yip, WW; Burt, AD (2006). "Alcoholic liver disease.". Semin Diagn Pathol 23 (3-4): 149–60. doi:10.1053/j.semdp.2006.11.002. PMID 17355088.
^ Liangpunsakul, S; Chalasani, N (Dec 2003). "Treatment of Nonalcoholic Fatty Liver Disease.". Curr Treat Options Gastroenterol 6 (6): 455–463. doi:10.1007/s11938-003-0047-0. PMID 14585234.

External links

Ballooning degeneration and feathery degeneration - what is the difference? - a T-shirt that asks the question - zcache.com.

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English Journal

Fetuin A is a Predictor of Liver Fat in Preoperative Patients with Nonalcoholic Fatty Liver Disease.

von Loeffelholz C1,2,3, Horn P2,3, Birkenfeld AL4, Claus RA2,3, Metzing BU2,3, Döcke S1, Jahreis G5, Heller R2,6, Hoppe S7, Stockmann M7, Lock JF8, Rieger A9, Weickert MO10, Settmacher U11, Rauchfuß F11, Pfeiffer AF1,12, Bauer M2,3, Sponholz C3.
Journal of investigative surgery : the official journal of the Academy of Surgical Research.J Invest Surg.2016 Mar 16:1-9. [Epub ahead of print]
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH) are frequent comorbidities in perioperative patients. However, the predictive role of the hepatokine fetuin A was not evaluated in this collective.OBJECTIVE: To study fetuin A as predictor of NAFLD/NASH in preoperative p
PMID 26980291

Antihyperlipidemic activity of adenosine triphosphate in rabbits fed a high-fat diet and hyperlipidemic patients.

Zhang L1, Liang L2, Tong T2, Qin Y2, Xu Y2, Tong X2.
Pharmaceutical biology.Pharm Biol.2016 Mar 9:1-6. [Epub ahead of print]
Context Recently, adenosine triphosphate (ATP) was occasionally found to decrease the triglyceride (TG) levels in several hyperlipidemic patients in our clinical practice. Objective The study investigates the anti-hyperlipidemic effects of ATP in a high-fat fed rabbit model and hyperlipidemic patien
PMID 26955742

Heat Shock Protein 27 is down-regulated in Ballooned Hepatocytes of Patients with Nonalcoholic Steatohepatitis (NASH).

Sookoian S1, Castaño GO2, Scian R1,3, San Martino J4, Pirola CJ3.
Scientific reports.Sci Rep.2016 Mar 3;6:22528. doi: 10.1038/srep22528.
Ballooning degeneration (BD) of hepatocytes is a distinguishing histological feature associated with the progression of nonalcoholic fatty liver disease (NAFLD). Under the assumption that NAFLD severity is associated with metabolic-stress we explored the hypothesis that heat shock 27 kDa protein 1
PMID 26935030

Japanese Journal

A fatal case of progressive steatohepatitis, possibly chemotherapy- associated steatohepatitis related to gemcitabine

Ren Xiangshan,Harada Kenichi,Yoshikawa Seiichi,Igarashi Saya,Urabe Takeshi,Yamada Shinya,Katayanagi Kazuyoshi,Kurumaya Hiroshi,Nakanuma Yasuni
Clinical Journal of Gastroenterology 3(4), 191-194, 2010-08
… Ballooning degeneration and necrosis of hepatocytes accompanying neutrophil infiltration, Mallory bodies, and a few bile plugs were found in zone 3. …
NAID 120002907452

Characterization of Liver Injury Associated with Hypersensitive Skin Reactions Induced by Trichloroethylene in the Guinea Pig Maximization Test

TANG Xiaojiang,QUE Bingling,SONG Xiangrong,LI Senhua,YANG Xiaojun,WANG Hailan,HUANG Hanlin,KAMIJIMA Michihiro,NAKAJIMA Tamie,LIN Yongcheng,LI Laiyu
Journal of occupational health 50(2), 114-121, 2008-03
… Evident fatty degeneration, hepatic sinusoid dilation and inflammatory cell infiltration were observed. … Lesions of ballooning changes were observed in liver pathology. … Interestingly, the histopathological features were quite different: fatty degeneration was most prominent in the former, and ballooning in the latter. …
NAID 110006680528