Clinical History
This 63-year old man had several previous admissions to hospital for bleeding from oesophageal varices. On admission he was noted to be mildly febrile, jaundiced with severe flapping tremor of his hands. He had a constellation of other findings including ascites, prominent periumbilical veins, and haemorrhoids. He had a massive haematemesis and died.

Pathology
A slice of liver has been mounted to display the cut surface, which shows multiple well-demarcated nodules varying in size from 1 to 7 mm in diameter. The external surface of the liver is also nodular and irregular. This is an example of cirrhosis of the liver, with a mixed micro- and macro-nodular pattern and marked fatty change.

Further Information
The commonest cause of cirrhosis and fatty change is chronic alcoholism.