Piecemeal necrosis

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Sclerotic piecemeal necrosis of the tip of the thumb in a patient with scleroderma.

Piecemeal necrosis generally refers to a necrosis that occurs in fragments.


When used in relation to the liver, piecemeal necrosis (also termed troxis necrosis,[1] nibbling necrosis[1] and interface necrosis[1]) refers specifically to a loss and degeneration of (limiting plate) hepatocytes at the lobular-portal-interface, producing a moth-eaten irregular appearance.[2] Piecemeal necrosis of the liver is associated with a lymphocytic infiltrate[2] into the adjacent parenchyma,[3] and with destruction of individual hepatocytes along the edges of the portal tract.[3]

It is a feature of viral hepatitis (especially chronic hepatitis) as well as autoimmune hepatitis and steatohepatitis.[1]


  1. ^ a b c d Wang, M.; Morgan, T.; Lungo, W.; Wang, L.; Sze, G. Z.; French, S. W. (2001). ""Piecemeal" Necrosis: Renamed Troxis Necrosis". Experimental and Molecular Pathology. 71 (2): 137–146. doi:10.1006/exmp.2001.2397. PMID 11599920. 
  2. ^ a b Pathbase > MPATH 597: cell and tissue damage process > MPATH 13: piecemeal necrosis Retrieved July 2, 2011
  3. ^ a b Transplant Pathology at the University of Pittsburgh > Chronic hepatitis > Chapter 3 > PATHOLOGIC FEATURES Last Modified: Mar 12, 2010