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Pathological findings that contribute to tissue stiffness in the spleen of liver cirrhosis patients
Author(s) -
Kondo Reiichiro,
Kage Masayoshi,
Iijima Hiroko,
Fujimoto Jiro,
Nishimura Takashi,
Aizawa Nobuhiro,
Akiba Jun,
Naito Yoshiki,
Kusano Hironori,
Nakayama Masamichi,
Mihara Yutaro,
Tanigawa Masahiko,
Yano Hirohisa
Publication year - 2018
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13195
Subject(s) - spleen , red pulp , pathology , cirrhosis , splenectomy , white pulp , medicine , mesenchymal stem cell , transient elastography , reticular cell , hydroxyproline , fibrosis , liver fibrosis
Aim Spleen stiffness is increased in liver cirrhosis (LC). We attempted to characterize the pathological features of spleen in LC. Methods We compared pathological findings of resected spleen tissues of 28 LC patients and those of six healthy controls. In addition, we measured spleen stiffness before splenectomy by shear wave elastography in nine LC patients. After splenectomy, we examined the relationship between spleen stiffness and pathological findings. Results Passive congestion of the spleen was more frequently observed in LC patients than in controls ( P < 0.01). The sinus was wider in LC patients than in controls ( P < 0.01). In the spleens of the LC patients, diffuse α‐smooth muscle actin (αSMA) expression of sinusoidal mesenchymal cells and deposition of collagen fibers on the perisinusoidal wall were observed. In nine LC patients whose spleen stiffness was examined, the width of the sinus increased along with spleen stiffness ( r = 0.89, P < 0.01). Spleen stiffness was higher in the spleen tissues with diffuse αSMA expression of sinusoidal mesenchymal cells than in those with partial αSMA expression of sinusoidal mesenchymal cells ( P = 0.01). The degree of fibrosis was higher in the LC patients with diffuse αSMA expression of the red pulp than in those with partial αSMA expression of the red pulp ( P = 0.03). Conclusion In the LC patients, spleen tissues showed passive congestion with a dilated sinus, diffuse αSMA expression of sinusoidal mesenchymal cells, and deposition of collagen fibers on the perisinusoidal wall. This contributed to spleen stiffness.