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《Beijing Medical Journal》 2019-10
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Pathological features of several non-cirrhotic portal hypertensive liver lesions

Liu Hui;Kong Heli;Song Chenzhao;Li Lei;Ding Huiguo;Department of Pathology, Beijing Youan Hospital, Capital Medical University;  
Objective To elucidate the pathological features of several common diseases associated with portal hypertension(PHT) in order to help clinicians understand such lesions from a pathological point of view. Methods The 134 cases pathologically diagnosed as non-cirrhotic portal hypertension(NCPH), hepatoportal sclerosis, idiopathic portal hypertension(IPH), congenital hepatic fibrosis(CHF), systemic diseases involving the liver were retrieved in Department of Pathology, Beijing Youan Hospital, Capital Medical University from January 2007 to December 2017. All the tissue slices were performed by HE staining, special staining for Masson trichrome and Reticulin were observed under light microscope. Their pathological features were summarized combined with clinical features and imaging data. Results Histological features of cirrhosis were not found in all cases. NCPH, hepatoportal sclerosis and IPH had the same pathological changes: luminal narrowing, sclerosis,or disappearance of the portal vein(PV) were the key histological changes in the portal tract(PT) which might show fibrosis without inflammation. The small branch of the PV dilated and herniated into the adjacent liver parenchyma. Sometimes the sinusoidal dilatation(megasinusoids) was seen in the parenchyma. CHF caused by ductal plate malformation, often resulted in PHT or cholangitis, but it was not true cirrhosis. Systemic disease, such as amyloidosis and myeloproliferative disorders,could also result in PHT. Conclusions Liver biopsy is essential for diagnosis of PHT,which not only can rule out cirrhosis,but also be able to confirmed the cause of NCPH.
【Fund】: 国家科技重大专项“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项(2017ZX10203202003008);; 北京市医院管理局——“扬帆”计划(ZYLX201610);北京市医院管理局“登峰”人才培养计划(DFL20150602);; 北京市卫生系统高层次卫生人才(2013-3-073)
【CateGory Index】: R575
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