Case 1, image 1: This was a 79 year old man who died from hemorrhagic pancreatitis due to chronic alcoholism. There is severe steatosis within the liver, which is not surprising.

Case 1, image 2: A closer look.

Case 1, image 3: There is macrovesicular steatosis and a few hepatocytes have microvesicular steatosis. You usually see both.

A fatty liver is almost an everyday finding in forensic pathology. The most common causes of macrovesicular steatosis include alcoholism and obesity. Other causes may include malnutrition, parental nutrition, Wilson disease, and some medications. Predominantly microvesicular steatosis carries a different differential diagnosis (i.e. Reye syndrome, certain medications, inborn errors of metabolism, HELLP syndrome).