title: Immunohistochemical study on the liver in autopsy cases with disseminated intravascular coagulation (DIC) with reference to clinicopathological analysis.
abstract: Immunohistochemical and clinicopathological studies were performed in 27 autopsy cases with indisputable DIC, which had been selected from 1,800 autopsy cases of elderly people based on the following two criteria; 1. presence of fibrin thrombi in glomeruli, and 2. presence of fresh patchy necrotic foci in myocardium and/or fibrin thrombi in splenic sinuses. A high incidence of liver lesions (22/27) was revealed in autopsy cases with indisputable DIC. The liver lesions could be classified into four groups. Group-I (Central degeneration) was characterized by massive precipitation of fibrin irregularly around the central vein, causing parenchymal damage. Group-II (Central necrosis), showed coagulation necrosis in the central zone due to circulatory disturbance caused by either shock as a cause of DIC or abrupt cessation of blood flow into the lobules following fibrin thrombus formation in vessels of Glisson's sheath. Both group-I and -II showed a short clinical duration of DIC. Group-III (Sinusoidal thrombosis), showed the presence of fibrin thrombi in sinusoids with mild parenchymal damage and long clinical duration of DIC. Group-IV (No thrombosis), showed neither parenchymal damage nor fibrin thrombi in sinusoids, but a long clinical duration of DIC.
mesh_terms: D000368:Aged; D002544:Cerebral Infarction / Q000150:complications; D004211:Disseminated Intravascular Coagulation / Q000209:etiology / Q000473:pathology*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications; D006651:Histocytochemistry; D006801:Humans; D007124:Immunoenzyme Techniques; D007678:Kidney Glomerulus / Q000473:pathology; D008099:Liver / Q000473:pathology*; D008297:Male; D009336:Necrosis; D013154:Spleen / Q000473:pathology; D013194:Staining and Labeling; D013927:Thrombosis / Q000150:complications