Hepatic veno-occlusive lesions and other histopathological changes of the liver in severe alcoholic hepatitis--a comparative clinicohistopathological study of autopsy cases.
BACKGROUND
The clinicopathological features of veno-occlusive lesions (VOL) in the liver were studied in 18 autopsy cases of severe alcoholic hepatitis (sALH). All the cases were heavy drinkers and died of liver failure or variceal rupture.


METHODS
We performed histological evaluation by examining stained sections of liver blocks from each case. The severity of VOL was compared with the clinical findings and histopathological changes of alcoholic liver diseases (ALD).


RESULTS
Clinically, as the severity of VOL increased, the amount of ascites observed during autopsy increased significantly (p = 0.001) and the time from hospitalization to death was significantly longer (p < 0.05). The peripheral leukocyte count tended to increase and the serum bilirubin level increased significantly (p < 0.05) with increased VOL severity, after we excluded one case that was complicated by acute respiratory distress syndrome and bacterial endocarditis. Histopathologically, the appearance of Mallory bodies increased significantly as VOL became more severe (p < 0.05), but the VOL severity did not correlate with sinusoidal neutrophil infiltration. Fatty degeneration tended to be milder as VOL increased in severity although the difference was not significant, whereas bile retention tended to be more marked.


CONCLUSIONS
We conclude that investigation of VOL is clinicopathologically important when assessing the pathophysiology and severity of sALH.
Kishi
M
M
Second Department of Pathology, St. Marianna University School of Medicine, Kawasaki, Japan.
Maeyama
S
S
Iwaba
A
A
Ogata
S
S
Koike
J
J
Uchikoshi
T
T
D000328:Adult; D001201:Ascites / Q000473:pathology; D001663:Bilirubin / Q000097:blood; D005260:Female; D006503:Hepatic Veins / Q000473:pathology; D006504:Hepatic Veno-Occlusive Disease / Q000209:etiology / Q000473:pathology*; D006519:Hepatitis, Alcoholic / Q000150:complications / Q000473:pathology*; D006801:Humans; D006984:Hypertrophy; D002479:Inclusion Bodies / Q000473:pathology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged
D001663:Bilirubin