ABSTRACT
DIAGNOSIS Nonalcoholic fatty liver disease (NAFLD) is a chronic disease, usually mild and commonly asymptomatic, characterized by the histologic features of macrovesicular steatosis with or without lobular (acinar) hepatitis in the absence of excess alcohol consumption (Fig. 1). NAFLD is a designation that encompasses patients with bland steatosis, active inflammation, or cirrhosis (Fig. 2). Nonalcoholic steatohepatitis (NASH) is within the spectrum of NAFLD and is associated with histologic activity. Transitions between NASH and bland steatosis probably occur. NASH may also result in cirrhosis (Fig. 3). Steatosis can diminish as patients progress to cirrhosis, and in some patients cryptogenic cirrhosis may have evolved from NAFLD.
