title: Peliosis hepatis in a kidney transplant recipient with manifestation as massive ascites and liver dysfunction: case report.
abstract: We report a case of 59-year-old woman who received a kidney transplant 7 years earlier without evidence of viral hepatitis history. She was asymptomatic initially and a newly developed nodule, ∼2.3 cm in size, was discovered in the right liver during routine sonographic examination. Computerized tomography-guided biopsy was inconclusive at that time. However, the lesion grew to 6.8 cm and bilobular multiple nodules developed with concomitant massive ascites and hyperbilirubinemia months later. Laparoscopy showed typical bluish-reddish-blackish nodules. Needle-biopsy histology showed severe sinusoid dilation and dropout of centrilobular hepatocytes consistent with peliosis hepatis. Reticulin staining also demonstrated disruption of sinusoidal reticulin fibers. We tried to withdraw possible offending drugs to anticipate regression of peliosis, but it failed and liver dysfunction progressed, leaving liver transplant as the last resort in such rare circumstances.
authors.affiliation: Department of Surgery, National Cheng-Kung University, Tainan, Taiwan.
authors.forename: W-H
authors.initials: WH
authors.lastname: Lui
authors.affiliation: Department of Surgery, National Cheng-Kung University, Tainan, Taiwan.
authors.forename: T-C
authors.initials: TC
authors.lastname: Chou
authors.affiliation: Department of Surgery, National Cheng-Kung University, Tainan, Taiwan.
authors.forename: S-S
authors.initials: SS
authors.lastname: Chang
authors.affiliation: Department of Surgery, National Cheng-Kung University, Tainan, Taiwan.
authors.forename: C-J
authors.initials: CJ
authors.lastname: Hung
authors.affiliation: Department of Surgery, National Cheng-Kung University, Tainan, Taiwan.
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Lin
authors.affiliation: Department of Surgery, National Cheng-Kung University, Tainan, Taiwan; Department of Surgery, Tainan Hospital, Tainan, Taiwan. Electronic address: pochang@mail.ncku.edu.tw.
authors.forename: P-C
authors.initials: PC
authors.lastname: Lee
mesh_terms: D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy; D016030:Kidney Transplantation; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010382:Peliosis Hepatis / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed