scholarly journals A CASE OF HEPATIC PSEUDOLESION SHOWING SINUSOIDAL DILATATION WITH NODULAR REGENERATIVE HYPERPLASIA-LIKE CHANGES

2007 ◽  
Vol 68 (8) ◽  
pp. 2045-2050
Author(s):  
Koichi KATO ◽  
Shuji NOMOTO ◽  
Hiroyuki SUGIMOTO ◽  
Naohito KANAZUMI ◽  
Shin TAKEDA ◽  
...  
Keyword(s):  
Nodular Regenerative Hyperplasia ◽  
Sinusoidal Dilatation ◽  
Hepatic Pseudolesion

Sinusoidal Dilatation and Congestion in Liver Biopsy: Is It Always Due to Venous Outflow Impairment?

2004 ◽  
Vol 128 (8) ◽  
pp. 901-904 ◽  
Author(s):  
Sanjay Kakar ◽  
Patrick S. Kamath ◽  
Lawrence J. Burgart
Keyword(s):  
Liver Biopsy ◽  
Portal Vein ◽  
Inflammatory Diseases ◽  
Gastric Bypass Surgery ◽  
Castleman Disease ◽  
Nodular Regenerative Hyperplasia ◽  
Venous Outflow ◽  
Sinusoidal Dilatation ◽  
Liver Biopsies ◽  
Clinical Records

Abstract Context.—Impairment of venous outflow manifests as zone 3 sinusoidal dilatation and congestion (SDC) in liver biopsy. However, the finding of SDC is not specific for venous outflow impairment. Objectives.—To determine the specificity of SDC in liver biopsies for venous outflow impairment and to seek an explanation for SDC in patients without clinical or radiologic features of venous outflow impairment. Design.—Liver biopsies from 51 patients with sinusoidal dilatation were reviewed. Biopsies from transplant recipients, patients with cirrhosis, and patients with hepatic neoplasms (primary or metastatic) were not included. Clinical records were reviewed for laboratory tests and final clinicopathologic diagnosis. Results.—Thirty-four patients (66.7%) had confirmed venous outflow impairment. Of the 17 cases (33.3%) without clinical and/or radiologic evidence of venous outflow impairment, vascular causes were present in 5 cases (9.8%; nodular regenerative hyperplasia in 2 cases and portal vein thrombosis, congenital absence of the portal vein, and sickle cell anemia in 1 case each). Systemic inflammatory disorders were identified in 6 patients (11.8%). These included 2 cases of Castleman disease and 1 each of sarcoidosis, Crohn disease, rheumatoid arthritis, and Still disease. Three patients (5.9%) had tumors without direct involvement of the liver (1 case each of Hodgkin lymphoma, renal cell carcinoma, and pancreatic serous pseudopapillary tumor). In the remaining 3 patients, SDC was identified in wedge liver biopsies performed at the time of surgery, including gastric bypass surgery, cholecystectomy, and splenectomy. No other disease association was apparent in these cases. Conclusion.—Sinusoidal dilatation and congestion in liver biopsy is associated with venous outflow impairment in two thirds of the cases. In the absence of clinical and/or radiological evidence of venous outflow, diagnostic considerations include other vascular conditions, such as portal vein insufficiency and nodular regenerative hyperplasia. Sinusoidal dilatation and congestion can also occur in the setting of systemic inflammatory diseases, granulomatous disorders, and neoplasms, as well as in wedge biopsies obtained during abdominal surgery.

scholarly journals Virtual Biopsy for Diagnosis of Chemotherapy-Associated Liver Injuries and Steatohepatitis: A Combined Radiomic and Clinical Model in Patients with Colorectal Liver Metastases

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 3077
Author(s):  
Guido Costa ◽  
Lara Cavinato ◽  
Chiara Masci ◽  
Francesco Fiz ◽  
Martina Sollini ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Laboratory Data ◽  
Unmet Need ◽  
Liver Parenchyma ◽  
Colorectal Metastases ◽  
Nodular Regenerative Hyperplasia ◽  
Clinical Model ◽  
Portal Phase ◽  
Sinusoidal Dilatation ◽  
Liver Injuries

Non-invasive diagnosis of chemotherapy-associated liver injuries (CALI) is still an unmet need. The present study aims to elucidate the contribution of radiomics to the diagnosis of sinusoidal dilatation (SinDil), nodular regenerative hyperplasia (NRH), and non-alcoholic steatohepatitis (NASH). Patients undergoing hepatectomy for colorectal metastases after chemotherapy (January 2018-February 2020) were retrospectively analyzed. Radiomic features were extracted from a standardized volume of non-tumoral liver parenchyma outlined in the portal phase of preoperative post-chemotherapy computed tomography. Seventy-eight patients were analyzed: 25 had grade 2–3 SinDil, 27 NRH, and 14 NASH. Three radiomic fingerprints independently predicted SinDil: GLRLM_f3 (OR = 12.25), NGLDM_f1 (OR = 7.77), and GLZLM_f2 (OR = 0.53). Combining clinical, laboratory, and radiomic data, the predictive model had accuracy = 82%, sensitivity = 64%, and specificity = 91% (AUC = 0.87 vs. AUC = 0.77 of the model without radiomics). Three radiomic parameters predicted NRH: conventional_HUQ2 (OR = 0.76), GLZLM_f2 (OR = 0.05), and GLZLM_f3 (OR = 7.97). The combined clinical/laboratory/radiomic model had accuracy = 85%, sensitivity = 81%, and specificity = 86% (AUC = 0.91 vs. AUC = 0.85 without radiomics). NASH was predicted by conventional_HUQ2 (OR = 0.79) with accuracy = 91%, sensitivity = 86%, and specificity = 92% (AUC = 0.93 vs. AUC = 0.83 without radiomics). In the validation set, accuracy was 72%, 71%, and 91% for SinDil, NRH, and NASH. Radiomic analysis of liver parenchyma may provide a signature that, in combination with clinical and laboratory data, improves the diagnosis of CALI.

scholarly journals A Reappraisal of Chemotherapy-Induced Liver Injury in Colorectal Liver Metastases before the Era of Antiangiogenics

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Eric Nguyen-Khac ◽  
Céline Lobry ◽  
Denis Chatelain ◽  
David Fuks ◽  
Jean Paul Joly ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Postoperative Mortality ◽  
Patient Characteristics ◽  
Nodular Regenerative Hyperplasia ◽  
Portal Fibrosis ◽  
Extensive Resection ◽  
Mortality And Morbidity ◽  
Sinusoidal Dilatation ◽  
Noncancerous Liver Tissue

Background and Aims.Chemotherapy of colorectal liver metastases can induce hepatotoxicity in noncancerous liver. We describe these lesions and assess risk factors and impacts on postresection morbidity and mortality in naive patients to chemotherapy before the era of bevacizumab.Methods.Noncancerous liver tissue lesions were analysed according to tumour, chemotherapy, surgery, and patient characteristics.Results.Fifty patients aged 62 ± 9.3 years were included between 2003 and 2007. Thirty-three (66%) received chemotherapy, with Folfox (58%), Folfiri (21%), LV5FU2 (12%), or Xelox (9%) regimens. Hepatotoxicity consisted of 18 (36%) cases of severe sinusoidal dilatation (SD), 13 (26%) portal fibrosis, 7 (14%) perisinusoidal fibrosis (PSF), 6 (12%) nodular regenerative hyperplasia (NRH), 2 (4%) steatosis >30%, zero steatohepatitis, and 16 (32%) surgical hepatitis. PSF was more frequent after chemotherapy (21% versus 0%, ), especially LV5FU2 (). SD was associated with oxaliplatin (54.5% versus 23.5%, ) and low body mass index (). NRH was associated with oxaliplatin () and extensive resection (). No impact on mortality and morbidity was observed, apart postoperative elevation of bilirubin levels in case of PSF (), longer hospitalization in case of surgical hepatitis (), and greater blood loss in case of portal fibrosis ().Conclusions.Chemotherapy of colorectal liver metastases induces sinusoidal dilatation related to oxaliplatin and perisinusoidal fibrosis related to 5FU, without any impact on postoperative mortality.

Nodular Regenerative Hyperplasia of the Liver in an Infant: Case Report

2002 ◽  
Vol 47 (6) ◽  
pp. 689 ◽  
Author(s):  
Ho Kyun Kim ◽  
Young Hwan Lee ◽  
Duck Soo Chung ◽  
Ok Dong Kim ◽  
Jin Bok Whang ◽  
...  
Keyword(s):  
Case Report ◽  
Nodular Regenerative Hyperplasia ◽  
Infant Case

Histopathology of liver biopsies from a thiopurine-naïve inflammatory bowel disease cohort: Prevalence of nodular regenerative hyperplasia

2008 ◽  
Vol 43 (5) ◽  
pp. 604-608 ◽  
Author(s):  
Nanne K. H. De Boer ◽  
Henriette Tuynman ◽  
Elisabeth Bloemena ◽  
Johan Westerga ◽  
Donald L. Van Der Peet ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Nodular Regenerative Hyperplasia ◽  
Inflammatory Bowel ◽  
Liver Biopsies

Hepatic fibrosis and cirrhosis in the Fontan circulation: a detailed morphological study

2007 ◽  
Vol 61 (4) ◽  
pp. 504-508 ◽  
Author(s):  
T J Kendall ◽  
B Stedman ◽  
N Hacking ◽  
M Haw ◽  
J J Vettukattill ◽  
...  
Keyword(s):  
Preoperative Assessment ◽  
Fontan Circulation ◽  
Severe Tricuspid Regurgitation ◽  
Histological Features ◽  
Sinusoidal Dilatation ◽  
Hepatocellular Damage ◽  
Biopsy Specimens ◽  
Inflammatory Mechanism ◽  
Spur Formation ◽  
Liver Biopsies

Aims:To describe the histological features of the liver in patients with a Fontan circulation.Methods:Specimens from liver biopsies carried out as part of preoperative assessment prior to extracardiac cavopulmonary conversion of an older style Fontan were examined and scored semi-quantitatively for pertinent histological features. To support the use of the scoring, biopsy specimens were also ranked by eye for severity to allow correlation with assigned scores.Results:Liver biopsy specimens from 18 patients with a Fontan circulation were assessed. All specimens showed sinusoidal fibrosis. In 17 cases there was at least fibrous spur formation, with 14 showing bridging fibrosis and 2 showing frank cirrhosis. In 17 cases at least some of the dense or sinusoidal fibrosis was orcein positive, although a larger proportion of the dense fibrous bands were orcein positive compared with the sinusoidal component. All specimens showed marked sinusoidal dilatation, and 14 showed bile ductular proliferation; 1 showed minimal iron deposition, and 1 showed mild lobular lymphocytic inflammation. There was no cholestasis or evidence of hepatocellular damage. Similar appearances were observed in 2 patients with severe tricuspid regurgitation.Discussion:The histological features of the liver in patients with a Fontan circulation are similar to those described in cardiac sclerosis. Sinusoidal dilatation and sinusoidal fibrosis are marked in the Fontan series. The presence of a significant amount of orcein negative sinusoidal fibrosis suggests there may be a remediable component, although the dense fibrous bands are predominantly orcein positive, suggesting chronicity and permanence. No inflammation or hepatocellular damage is evident, suggesting that fibrosis may be mediated by a non-inflammatory mechanism.

Drug-Induced Nodular Regenerative Hyperplasia

2014 ◽  
Vol 34 (02) ◽  
pp. 240-245 ◽  
Author(s):  
Marwan Ghabril ◽  
Raj Vuppalanchi
Keyword(s):  
Nodular Regenerative Hyperplasia ◽  
Drug Induced

Unusual Nodular Regenerative Hyperplasia Mimicking Liver Metastases in CEUS

2014 ◽  
Vol 35 (03) ◽  
pp. 199-202
Author(s):  
M Höpfner ◽  
A Scheel ◽  
M Braun ◽  
J Rüschoff ◽  
C Löser
Keyword(s):  
Liver Metastases ◽  
Nodular Regenerative Hyperplasia
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