title: Non-cirrhotic portal hypertension with large regenerative nodules: a diagnostic challenge.
abstract: Non-cirrhotic portal hypertension is a poorly understood condition characterized by portal hypertension in the absence of conventional hepatic cirrhosis and described in association with blood coagulation disorders, myeloproliferative and immunological diseases and with exposure to toxic drugs. Very recently, precise classification criteria have been proposed in order to define four distinct subcategories. The present case highlights how the clinical presentation, the confounding results from imaging studies, and the difficulties in the histological evaluation often render cases of non-cirrhotic portal hypertension a real diagnostic challenge. It also underscores the classification problems which can be faced once this diagnosis is performed. Indeed, the different subcategories proposed result from the prevalent subtypes in a spectrum of hepatic regenerative responses to a variety of injuries determining microcirculatory disturbances. More flexibility in classification should derive from this etiopathogenic background.
authors.affiliation: Clinical Medicine and Hepatology Unit, University Campus Bio-Medico of Rome, 00128 Rome, Italy. u.vespasiani@unicampus.it
authors.forename: Umberto Vespasiani
authors.initials: UV
authors.lastname: Gentilucci
authors.forename: Paolo
authors.initials: P
authors.lastname: Gallo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Perrone
authors.forename: Riccardo
authors.initials: R
authors.lastname: Del Vescovo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Galati
authors.forename: Sandro
authors.initials: S
authors.lastname: Spataro
authors.forename: Chiara
authors.initials: C
authors.lastname: Mazzarelli
authors.forename: Adriano
authors.initials: A
authors.lastname: Pellicelli
authors.forename: Antonella
authors.initials: A
authors.lastname: Afeltra
authors.forename: Antonio
authors.initials: A
authors.lastname: Picardi
mesh_terms: D001706:Biopsy; D006801:Humans; D006975:Hypertension, Portal / Q000145:classification* / Q000175:diagnosis* / Q000473:pathology; D008099:Liver / Q000473:pathology*; D008115:Liver Regeneration; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged