The role of granulomatous phlebitis and thrombosis in the pathogenesis of cirrhosis and portal hypertension in sarcoidosis

被引:56
作者
MorenoMerlo, F
Wanless, IR
Shimamatsu, K
Sherman, M
Greig, P
Chiasson, D
机构
[1] TORONTO GEN HOSP,DEPT PATHOL,CANADIAN LIVER PATHOL REFERENCE CTR,TORONTO,ON M5G 2C4,CANADA
[2] TORONTO GEN HOSP,DEPT MED,CANADIAN LIVER PATHOL REFERENCE CTR,TORONTO,ON M5G 2C4,CANADA
[3] TORONTO GEN HOSP,DEPT SURG,CANADIAN LIVER PATHOL REFERENCE CTR,TORONTO,ON M5G 2C4,CANADA
关键词
HEPATIC SARCOIDOSIS; DISEASE; CHOLESTASIS;
D O I
10.1002/hep.510260304
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Sarcoidosis often involves the liver with mild elevation of serum enzymes and granulomas histologically. Rarely, chronic cholestasis, portal hypertension, cirrhosis, or nodular hyperplasia may be found. The pathogenesis of the portal hypertension and of the cirrhosis are not understood. In part because large samples of tissue have seldom been described. We describe the clinical and anatomic findings of four patients with sarcoid liver disease in whom the whole livers were available for examination. One patient had cirrhosis, one had diffuse nodular hyperplasia, and two had small regions of parenchymal fibrosis. The first two of these had a history of variceal bleeding and healed portal vein thrombosis. One had chronic cholestasis without cirrhosis. We suggest that the cirrhosis and focal fibrosis were caused by ischemia secondary to primary granulomatous phlebitis of portal and hepatic veins. The portal hypertension in two patients was likely secondary to portal vein thrombosis, because cirrhosis was absent at the onset of variceal bleeding.
引用
收藏
页码:554 / 560
页数:7
相关论文
共 29 条
[21]   PARTIAL NODULAR TRANSFORMATION OF LIVER WITH PORTAL HYPERTENSION [J].
SHERLOCK, S ;
FELDMAN, CA ;
MORAN, B ;
SCHEUER, PJ .
AMERICAN JOURNAL OF MEDICINE, 1966, 40 (02) :195-+
[22]   PULMONARY VASCULAR INVOLVEMENT IN SARCOIDOSIS - A REPORT OF 40 AUTOPSY CASES [J].
TAKEMURA, T ;
MATSUI, Y ;
SAIKI, S ;
MIKAMI, R .
HUMAN PATHOLOGY, 1992, 23 (11) :1216-1223
[23]  
TEKESTE H, 1984, AM J GASTROENTEROL, V79, P389
[24]  
VALLA D, 1987, Q J MED, V63, P531
[25]  
VILINSKAS J, 1970, AM J SURG, V120, P393
[26]  
Wanless I R, 1996, Prog Liver Dis, V14, P265
[27]  
WANLESS IR, 1995, HEPATOLOGY, V21, P1232, DOI 10.1002/hep.1840210504
[28]  
WANLESS IR, 1987, FALK S, V44, P293
[29]  
WINDLER E, 1983, Z GASTROENTEROL, V21, P115