Nonalcoholic steatohepatitis or NASH is a common, often “silent” liver disease. It resembles alcoholic liver disease, but occurs in people who drink little or no alcohol. The major feature in NASH is fat in the liver, along with inflammation and damage. NASH can be severe and can lead to cirrhosis, in which the liver is permanently damaged and scarred and no longer able to work properly, Histopathology of NASH • Spectrum of NAFLD include steatosis alone (type I)• Steatosis plus inflammation (type II) • Steatosis + hepatocyte injury or ballooning degeneration (type III) • Steatosis plus sinusoidal fibrosis and Mallory bodies (type IV or both type IV-IX) • NASH is considered the most severe form of NAFLD