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Terminal hepatic venule injury in liver biopsies of allogeneic haematopoietic stem cell recipients—a study of 63 cases
Author(s) -
Ma Changqing,
Brunt Elizabeth M
Publication year - 2016
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.12887
Subject(s) - medicine , biopsy , liver injury , cyclophosphamide , haematopoiesis , stem cell , gastroenterology , liver biopsy , pathology , chemotherapy , biology , genetics
Aims Subtle lesions of terminal hepatic venules ( THV s) may be overlooked in liver biopsies from haematopoietic stem cell transplant ( HSCT ) receipients when graft‐versus‐host disease is the clinical concern. The aim of this study was to evaluate the frequency of THV injury resembling sinusoidal obstruction syndrome ( SOS ). Methods and results Sixty‐three consecutive biopsies from allogeneic HSCT recipients were scored for injured THV s. Forty‐nine (78%) biopsies had injured THV s, and 10 (16%) were diagnosed with SOS (mean ± standard deviation of injured THV s/biopsy: 90 ± 9%). Biopsies diagnosed with other diseases also had injured THV s (36 ± 33%). Biopsies from patients with cyclophosphamide plus fractionated total body irradiation conditioning and biopsies taken within 100 days post‐ HSCT had significantly more occluded THV s (respectively: 40 ± 38%, P = 0.0188; and 35 ± 35%, P = 0.0076) than those with other conditioning regimens or in biopsies taken >100 days post‐ HSCT . All biopsies taken at any time in the 6‐year post‐ HSCT period had similar amounts of THV phlebosclerosis (23 ± 25%). Conclusions Our results demonstrate a high incidence of THV injuries resembling SOS in post‐ HSCT liver biopsies. THV injuries were detectable for several years post‐ HSCT , and were concurrent with other diagnoses. Our results also suggest that SOS may be underdiagnosed.