Venoocclusive Disease

Published on 21/04/2017 by admin

Filed under Pathology

Last modified 21/04/2017

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Marked Congestion
In severe cases, venoocclusive disease is characterized by marked congestion in the sinusoids and can be accompanied by areas of hemorrhage image .

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Congestion and Plate Atrophy
Endothelial injury in sinusoids and small hepatic veins leads to venous outflow obstruction that manifests as sinusoidal dilatation, congestion, and hepatic plate atrophy.
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Venous Occlusion
Endothelial swelling with subendothelial edema and fibrosis image leads to partial occlusion of the lumen of a small hepatic vein in venoocclusive disease. These characteristic lesions may not be evident in biopsies.
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Sickle Cell Crisis
Sinusoidal obstruction caused by occlusion of hepatic sinusoids by sickled red blood cells image in hepatic sickle cell crisis is shown. This is a rare phenomenon but can cause sinusoidal obstruction syndrome and present in an acute fashion.

TERMINOLOGY

Abbreviations

• Venoocclusive disease (VOD)

Synonyms

• Sinusoidal obstruction syndrome (SOS)

ETIOLOGY/PATHOGENESIS

Etiology

• Stem cell transplantation and high-dose chemotherapy
• Herbal medicines containing pyrrolizidine alkaloids
• Rare complication of liver transplantation
• Rare causes of sinusoidal obstruction: Sickle cell crisis, Plasmodium falciparum malaria, extensive infiltration by neoplastic cells

Risk Factors

• Older age and poor performance status
• HLA disparity in allogeneic stem cell transplant
• Preexisting liver dysfunction
• Prior abdominal radiation
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