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Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1986 Jan;39(1):63–67. doi: 10.1136/jcp.39.1.63

Hepatic vein lesions in alcoholic liver disease: retrospective biopsy and necropsy study.

A D Burt, R N MacSween
PMCID: PMC499614  PMID: 3950032

Abstract

Obliteration of the terminal hepatic venules with perivenular fibrosis (phlebosclerosis) is a well recognised feature in alcoholic liver disease. Veno-occlusive lesions with intimal obliteration of hepatic veins and a lymphocytic phlebitis of hepatic veins may also be present. We looked for these lesions in 256 liver biopsies and 50 livers obtained at necropsy from patients with alcoholic liver disease. Phlebosclerosis was a universal finding in alcoholic hepatitis and cirrhosis and showed increasing severity with progressive liver injury. Veno-occlusive lesions, however, were found in only 25 of 256 (9.8%) of biopsies and 11 of 50 (22%) of livers obtained at necropsy, showing alcoholic hepatitis or cirrhosis: lymphocytic phlebitis was found in 10 of 256 (3.9%) and two of 50 (4%), respectively. Moreover, veno-occlusive lesions were generally mild. The prevalence of veno-occlusive lesions and lymphocytic phlebitis was considerably less than has been previously documented. Phlebosclerosis may have a different mechanism and be a more important contributory factor in progressive liver injury.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alcoholic liver disease: morphological manifestations. Review by an international group. Lancet. 1981 Mar 28;1(8222):707–711. [PubMed] [Google Scholar]
  2. BRAS G., JELLIFFE D. B., STUART K. L. Veno-occlusive disease of liver with nonportal type of cirrhosis, occurring in Jamaica. AMA Arch Pathol. 1954 Apr;57(4):285–300. [PubMed] [Google Scholar]
  3. Brooks S. E., Miller C. G., McKenzie K., Audretsch J. J., Bras G. Acute veno-occlusive disease of the liver. Fine structure in Jamaican children. Arch Pathol. 1970 Jun;89(6):507–520. [PubMed] [Google Scholar]
  4. EDMONDSON H. A., PETERS R. L., REYNOLDS T. B., KUZMA O. T. SCLEROSING HYALINE NECROSIS OF THE LIVER IN THE CHRONIC ALCOHOLIC. A RECOGNIZABLE CLINICAL SYNDROME. Ann Intern Med. 1963 Nov;59:646–673. doi: 10.7326/0003-4819-59-5-646. [DOI] [PubMed] [Google Scholar]
  5. Edmondson H. A. Pathology of alcoholism. Am J Clin Pathol. 1980 Nov;74(5):725–742. doi: 10.1093/ajcp/74.5.725. [DOI] [PubMed] [Google Scholar]
  6. Fleming K. A., McGee J. O. Alcohol induced liver disease. J Clin Pathol. 1984 Jul;37(7):721–733. doi: 10.1136/jcp.37.7.721. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Gill R. A., Onstad G. R., Cardamone J. M., Maneval D. C., Sumner H. W. Hepatic veno-occlusive disease caused by 6-thioguanine. Ann Intern Med. 1982 Jan;96(1):58–60. doi: 10.7326/0003-4819-96-1-58. [DOI] [PubMed] [Google Scholar]
  8. Goodman Z. D., Ishak K. G. Occlusive venous lesions in alcoholic liver disease. A study of 200 cases. Gastroenterology. 1982 Oct;83(4):786–796. [PubMed] [Google Scholar]
  9. Griner P. F., Elbadawi A., Packman C. H. Veno-occlusive disease of the liver after chemotherapy of acute leukemia. Report of two cases. Ann Intern Med. 1976 Nov;85(5):578–582. doi: 10.7326/0003-4819-85-5-578. [DOI] [PubMed] [Google Scholar]
  10. Nakano M., Worner T. M., Lieber C. S. Perivenular fibrosis in alcoholic liver injury: ultrastructure and histologic progression. Gastroenterology. 1982 Oct;83(4):777–785. [PubMed] [Google Scholar]
  11. Nakanuma Y., Ohta G., Doishita K. Quantitation and serial section observations of focal venocclusive lesions of hepatic veins in liver cirrhosis. Virchows Arch A Pathol Anat Histopathol. 1985;405(4):429–438. doi: 10.1007/BF00737169. [DOI] [PubMed] [Google Scholar]
  12. Nasrallah S. M., Nassar V. H., Galambos J. T. Importance of terminal hepatic venule thickening. Arch Pathol Lab Med. 1980 Feb;104(2):84–86. [PubMed] [Google Scholar]
  13. Popper H., Thung S. N., Gerber M. A. Pathology of alcoholic liver diseases. Semin Liver Dis. 1981 Aug;1(3):203–216. doi: 10.1055/s-2008-1041748. [DOI] [PubMed] [Google Scholar]
  14. STIRLING G. A., BRAS B., URQUHART A. E. The early lesions in veno-occlusive disease of the liver. Arch Dis Child. 1962 Oct;37:535–538. doi: 10.1136/adc.37.195.535. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Van Waes L., Lieber C. S. Early perivenular sclerosis in alcoholic fatty liver: an index of progressive liver injury. Gastroenterology. 1977 Oct;73(4 Pt 1):646–650. [PubMed] [Google Scholar]

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