This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pathology
[{'content': 'A liver biopsy reveals following findings. What is true about this condition \nSelect and explain. \nA. Nodular regenerative hyperplasia of liver induced due to OCP, B. Nutmeg liver with dark areas of perivenular dead hepatocytes and gray areas of periportal viable hepatocytes, C. Nutmeg liver with pale areas of necrosis and dark congested areas of perivenular viable hepatocytes, D. Cirrhotic liver with fibrotic nodules.', 'role': 'user'}, {'content': 'Answer: B \nExplanation: This is a classical picture of nutmeg liver seen in chronic passive venous congestion on the liver.\nThe dark congested areas consist of necrotic hepatocytes while the surrounding paler and brownish appearing regions are viable hepatocytes.\n\n"The combination of hypoperfusion and retrograde congestion acts synergistically to cause centrilobular hemorrhagic necrosis.\nThe liver takes on a variegated mottled appearance, reflecting haemorrhage and necrosis in the centrilobular regions.\nThis finding is known as nutmeg liver due to its resemblance to the cut surface of a nutmeg. ”\n—\xa0Robbins 9/e p864\xa0\n\nPassive Congestion and Centrilobular Necrosis Hepatic manifestations of systemic circulatory compromise-passive congestion & centrilobular necrosis can be seen in both left & right-sided heart failure.\nPathology\nRight-sided cardiac decompensation leads to passive congestion of the liver.\nThe liver is slightly enlarged, tense, and cyanotic, with rounded edges.\nMicroscopically there is congestion of centrilobular sinusoids.\nWith time, centrilobular hepatocytes become atrophic, resulting in markedly attenuated liver cell plates.\nLeft-sided cardiac failure or shock may lead to hepatic hypoperfusion & hypoxia, causing ischemic coagulative necrosis of hepatocytes in the central region of the lobule (centrilobular necrosis). Combination of hypoperfusion & retrograde congestion acts synergistically to cause centrilobular hemorrhagic necrosis.\nThe liver takes on a variegated mottled appearance, reflecting hemorrhage & necrosis in the centrilobular regions.\nThis finding is known as nutmeg liver due to its resemblance to the cut surface of a nutmeg.', 'role': 'assistant'}]