title: Sinusoidal obstruction syndrome (SOS): A light and electron microscopy study in human liver.
abstract: OBJECTIVE
  Oxaliplatin is an important chemotherapeutic agent, used in the treatment of hepatic colorectal metastases, and known to induce the sinusoidal obstruction syndrome (SOS). Pathophysiological knowledge concerning SOS is based on a rat model. Therefore, the aim was to perform a comprehensive study of the features of human SOS, using both light microscopy (LM) and electron microscopy (EM).
  
  
  RESULTS
  Included were all patients of whom wedge liver biopsies were collected during a partial hepatectomy for colorectal liver metastases, in a 4-year period. The wedge biopsy were perfusion fixated and processed for LM and EM. The SOS lesions were selected by LM and details were studied using EM. Material was available of 30 patients, of whom 28 patients received neo-adjuvant oxaliplatin. Eighteen (64%) of the 28 patients showed SOS lesions, based on microscopy. The lesions consisted of sinusoidal endothelial cell detachment from the space of Disse on EM. In the enlarged space of Disse a variable amount of erythrocytes were located.
  
  
  CONCLUSIONS
  Sinusoidal endothelial cell detachment was present in human SOS, accompanied by enlargement of the space of Disse and erythrocytes in this area. These findings, originally described in a rat model, were now for the first time confirmed in human livers under clinically relevant settings.
authors.affiliation: Department of Pathology, Maastricht University Medical Centre, Maastricht, The Netherlands; Department of Pathology, Amphia Hospital, Breda, The Netherlands. Electronic address: celienvreuls@hotmail.com.
authors.forename: C P H
authors.initials: CP
authors.lastname: Vreuls
authors.affiliation: Department of Pathology, Antwerp University Hospital, Edegem, Belgium; University of Antwerp, Antwerp, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Driessen
authors.affiliation: Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands; NUTRIM School for Nutrition and Translational Research in Metabolism, and GROW: School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands; Department of HPB Surgery, Royal Free Hospital, London, United Kingdom.
authors.forename: S W M
authors.initials: SW
authors.lastname: Olde Damink
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre, Maastricht, The Netherlands; NUTRIM, School for Nutrition, Toxocology and Metabolism, Maastricht, The Netherlands.
authors.forename: G H
authors.initials: GH
authors.lastname: Koek
authors.affiliation: Maastricht Multimodal Molecular Imaging Institute, Division of Nanoscopy, University of Maastricht, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Duimel
authors.affiliation: Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands; NUTRIM School for Nutrition and Translational Research in Metabolism, and GROW: School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: M A J
authors.initials: MA
authors.lastname: van den Broek
authors.affiliation: Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands; NUTRIM School for Nutrition and Translational Research in Metabolism, and GROW: School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: C H C
authors.initials: CH
authors.lastname: Dejong
authors.affiliation: Maastricht Multimodal Molecular Imaging Institute, Division of Nanoscopy, University of Maastricht, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Braet
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre, Maastricht, The Netherlands; NUTRIM, School for Nutrition, Toxocology and Metabolism, Maastricht, The Netherlands; Maastricht Multimodal Molecular Imaging Institute, Division of Nanoscopy, University of Maastricht, The Netherlands; School of Medical Sciences (Discipline of Anatomy and Histology) - The Bosch Institute and Australian Centre for Microscopy & Microanalysis, The University of Sydney, Australia.
authors.forename: E
authors.initials: E
authors.lastname: Wisse
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001706:Biopsy; D002196:Capillaries / Q000166:cytology / Q000648:ultrastructure; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000473:pathology; D004727:Endothelium / Q000648:ultrastructure; D006498:Hepatectomy; D006504:Hepatic Veno-Occlusive Disease / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology* / Q000648:ultrastructure*; D008113:Liver Neoplasms / Q000188:drug therapy / Q000601:surgery; D008297:Male; D008854:Microscopy, Electron / Q000379:methods; D008859:Microscopy, Polarization / Q000379:methods; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D000077150:Oxaliplatin
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin
keywords: Electron microscopy; Human; Light microscopy; Liver; Oxaliplatin; Sinusoidal obstruction syndrome