Summary
The pathogenesis and functional significance of the venocclusive (VO) lesions in small hepatic veins occurring in liver cirrhosis, remain controversial. The present study, using quantitative examination and serial sections has disclosed that these lesions are present in 71.7% of 106 autopsy livers with alcoholic, HBsAg-positive, biliary or cryptogenic cirrhosis. The lesions were usually focal: their number in a liver section (10 cm2) was below 15 in 86.7% of the livers having them. The incidence and morphology of the lesions appeared similar in cirrhotic livers with different aetiology. Serial sections disclosed that the affected veins disappeared within the fibrous stroma at one side and were directly connected with the patent larger hepatic veins at other side, indicating that these veins had lost their function as a draining vein of the hepatic parenchyma. In addition, there was frequent recanalization within the VO lesions, and the recanalized vessels frequently communicated with neighboring thin-walled veins in cirrhotic stroma, suggesting an intrahepatic vein to vein anastomosis. In conclusion, VO lesions, when focal, may themselves be responsible to a lesser degree for obstruction of hepatic venous outflow in liver cirrhosis.
Similar content being viewed by others
References
Bookstein JJ, Appelman HD, Walter JF, Foley WD, Turcotte JG, Lambert M (1975) Histological-venographic correlates in portal hypertension. Diag Radiol 116:565–573
Bras G, Jelliffe DB, Stuart KL (1954) Veno-occlusive disease of the liver with non-portal type of cirrhosis occurring in Jamaica. Arch Pathol 57:285–300
Fajardo LF, Colby IV (1980) Pathogenesis of veno-occlusive liver disease after radiation. Arch Pathol Lab Med 104:584–588
Futagawa S, Fukasawa M, Musha H, Isomatsu T, Koyama K, Ito T, Horisawa M, Nakayama S, Sugiura M, Kameda H, Okuda K (1981) Hepatic venography in noncirrhotic idiopathic portal hypertension. Comparison with cirrhosis of the liver. Radiology 141:303–309
Goodman ZD, Ishak KG (1982) Occlusive venous lesions in alcoholic liver disease. A study of 200 cases. Gastroenterol 83:786–796
Lehman H, Kaiserling E, Schlaak M (1982) Left hepatic lobe atrophy and partial Budd-Chiari syndrome in a patient with alcoholic liver cirrhosis. Hepatogastroenterol 29:3–5
Nakanuma Y, Ohta G, Maki H, Doishita K (1980) Granulomatous liver disease in the small hepatic and portal veins. Arch Pathol Lab Med 104:456–458
Popper H (1977) Pathologic aspects of cirrhosis. Am J Pathol 87:228–264
Sano Y (1976) Histological technics; Theoretical and applied. 5th ed. Tokyo: Nanzando Co. (In Japanese)
Shikata T, Uzawa T, Yoshiwara N, Akatsuka T, Yamazawa S (1974) Staining methods of Australia antigen in paraffin section - detection of cytoplasmic includsion bodies. Jap J Exp Med 44:25–36
Shulman HM, McDonald GB, Matthews D, Doney KC, Kopecky KJ, Gauvreau JM, Thomas ED (1980) An analysis of hepatic venocclusive disease and centrilobular hepatic degeneration following bone marrow transplantation. Gastroenterology 79:1178–1191
Takayasu K, Musha H, Nakazima Y, Okuda J (1978) Clinical evaluation of hepatic vein catherization - differential diagnosis of liver cirrhosis from other liver diseases based on venograms. Jpn J Gastroenterol 75:1623–1633
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Nakanuma, Y., Ohta, G. & Doishita, K. Quantitation and serial section observations of focal venocclusive lesions of hepatic veins in liver cirrhosis. Vichows Archiv A Pathol Anat 405, 429–438 (1985). https://doi.org/10.1007/BF00737169
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00737169