Morphometry of terminal hepatic veins
- 21 Downloads
- 8 Citations
Summary
Alcohol induced perivenular fibrosis of terminal hepatic veins (THV) is claimed to be a precursor lesion leading to fibrosis development in man and baboon. The nature and significance of the THV lesions found in four baboons chronically fed with alcohol were studied in liver biopsies obtained during a three year period. The surface of THV wall and the number of mesenchymal cells were assessed with a semi-automatic image analyser. Histologically, THV were characterized as (a) phlebitic, in the presence of an inflammatory cell infiltrate involving the venous wall; (b) oedematous, when the connective tissue of the THV wall was disrupted or dissociated and (c) fibrotic, when perivenular scarring appeared as an increased rim. These lesions were present simultaneously and their intensity and distribution were independent of the duration of alcohol intoxication. Morphometric data obtained from these THV confirmed the thickening of the THV wall (WS/IS in: oedematous 1.05±0.36; phlebitic 1.65±1.04; fibrotic 1.47±0.36); and revealed an increased number of mesenchymal cells in fibrotic (439 μm2/cell;p<0.01) and in phlebitic THV (510 μm2/cell;p<0.05). A constant relationship was found between phlebitis and the presence of inflammatory infiltrate within the hepatic acini. Fibrotic THV was a less frequent finding and the lesion disappeared in the sequential biopsies of one of the baboons. In conclusion, THV lesions were heterogeneous and the collagen deposition in the THV wall was potentially reversible during the three year alcohol intoxication period, regardless the inflammatory reaction and, thus, did not indicate early irreversible hapatic fibrosis.
Key words
Alcoholic liver disease Terminal hepatic veins Baboon Fibrosis MorphometryPreview
Unable to display preview. Download preview PDF.
References
- Baptista A (1981) Alcoholic liver disease: morphological manifestations. Lancet i:707–711Google Scholar
- Burt AD, MacSween RNM (1986) Hepatic vein lesion in alcoholic liver disease: retrospective biopsy study and necropsy study. J Clin Pathol 39(1):63–67Google Scholar
- Christoffersen P, Nielsen K (1972) Histologic changes in liver biopsies from chronic alcoholics. Acta Path Microbiol Scand (Section A) 80:557–565Google Scholar
- Davidson CS (1986) Changing concepts in the pathogenesis of alcoholic liver disease. Alcohol Clin Exp Res 10 (6):3S-4SGoogle Scholar
- Desmet VJ (1985) Alcoholic liver disease. Histological features and evolution. Acta Med Scand S703:111–126Google Scholar
- Edmondson HA, Peters RL, Reynolds TB, Kuzma OT (1963) Sclerosing hyalin necrosis of the liver in the chronic alcoholic. A recognizable clinical syndrome. Ann Inter Med 59:646–672Google Scholar
- Fallon HJ (1982) Alcohol and terminal hepatic venule. Early lesion or late residual? Gastroenterology 83:930–932Google Scholar
- Fleming KA, McGee JO'D (1984) Alcohol induced liver disease. J Clin Pathol 37:721–733Google Scholar
- French SW, Burbige EJ, Tarder G, Bourke E, Harkin CG, Denton T (1979) Lymphocyte sequestration by liver in alcoholic hepatitis. Arch Pathol Lab Med 103:146–152Google Scholar
- Galambos JT (1972) Natural history of alcoholic hepatitis. III. Histologic changes. Gastroenterology 63:1026–1035Google Scholar
- Goodmann ZD, Ishak KG (1982) Occlusive venous lesions in alcoholic liver disease. A study of 200 cases. Gastroenterology 83:786–796Google Scholar
- Grimaud J-A (1985) Immunoelectron microscopy for collagen types differentiation in portal hepatic fibrosis. In: Gerlach U, Pott G, Rauterberg J, Voss B (eds) Connective tissue of the normal and fibrotic human liver. George Thieme Verlag, Stuttgart, pp 30–33Google Scholar
- Hall PM (1985) Pathology and pathogenesis of alcoholic liver diseases. In: Hall P (ed) Alcoholic liver diseases. Edward Arnold, London, pp 41–68Google Scholar
- Junge J, Horn T, Christoffersen P (1987) Megamitochondria as a diagnostic marker for alcohol induced centrilobular and periportal fibrosis in the liver. Virchows Arch [A] 410(6):553–558Google Scholar
- Lane BP, Lieber CS (1966) Ultrastructural alterations in human hepatocytes following ingestion of ethanol with adequate diets. Am J Pathol 49(4):593–603Google Scholar
- Lieber CS (1982) Ethanol, steatosis and fibrosis. In: Gerlach U, Pott G, Rauterberg J, Voss B (eds) Connective Tissue of the Normal and Fibrotic Human Liver. George Thieme Verlag, Stuttgart, pp 107–111Google Scholar
- Lieber CS (1983) Precursor lesions of cirrhosis. Alcohol Alcoholism 18(1):5–20Google Scholar
- Lieber CS (1985a) Alcohol and the liver: metabolism of ethanol. Metabolic effects and pathogenesis of injury. Acta Med Scand S703:11–55Google Scholar
- Lieber CS (1985b) Alcohol metabolism. In: Hall P (ed) Alcoholic Liver Diseases. Edward Arnold, London, pp 3–40Google Scholar
- Lieber CS, deCarli LM (1974) An experimental model of alcohol feeding and liver injury in the baboon. J Med Prim 3:153–163Google Scholar
- Lieber CS, deCarli LM (1976) Animal models of ethanol dependence and liver injury in rats and baboons. Fed Proc 35:1232–1236Google Scholar
- Lieber CS, deCarli LM, Rubin E (1975) Sequential production of fatty liver, hepatitis and cirrhosis in sub-human primates fed ethanol with adequate diets. Proc Nat Acad Sci USA 72:437–441Google Scholar
- Lieber CS, Leo MA (1986) Interaction of alcohol and nutritional factors with hepatic fibrosis. In: Popper H, Schaffner F (eds) Progress in Liver Diseases, vol. VIII, chapter 14. Grune and Stratton, pp 253–272Google Scholar
- MacSween RNM (1985) Alcohol and liver injury: genetic and immunological factors. Acta Med Scand S703:57–65Google Scholar
- MacSween RNM, Burt AD (1986) Histologic spectrum of alcoholic liver disease. Sem Liver Dis 6 (3):221–232Google Scholar
- Mak KM, Leo MA, Lieber CS (1984) Alcoholic liver injury in baboons. Transformation of lipocytes to transitional cells. Gastroenterology 87:188–200Google Scholar
- McGee JO'D, Patrick RS (1972) The role of perisinusoidal cells in hepatic fibrogenesis. Lab Invest 26 (4):429–440Google Scholar
- Milton JS, Tsokos JO (1983) Statistical methods in the biological and health sciences. McGraw-Hill, New YorkGoogle Scholar
- Minato Y, Hasumura Y, Takeuchi J (1983) The role of fat-storing cells in Disse space fibrogenesis in alcoholic liver disease. Hepatology 3:559–566Google Scholar
- Nakano M, Lieber CS (1982) Ultrastructure of initial stages of perivenular fibrosis in alcohol-fed baboons. Am J Pathol 106:145–155Google Scholar
- Nakano M, Worner TM, Lieber CS (1982) Perivenular fibrosis in alcoholic liver injury: ultrastructure and histologic progression. Gastroenterology 83:777–785Google Scholar
- Nasrallah SM, Nassar VH, Galambos JT (1980) Importance of terminal hepatic venule thickning. Arch Pathol Lab Med 104:84–86Google Scholar
- Okanoue T, Burbige EJ, French SW (1983) The role of the Ito cells in the perivenular and intralobular fibrosis of alcoholic hepatitis. Arch Pathol Lab Med 107:459–463Google Scholar
- Orrego H, Medline A, Blendis LM, Rankin JG, Kreaden DA (1979) Collagenisation of the Disse space in alcoholic liver disease. Gut 20:673–679Google Scholar
- Popper H, Lieber CS (1980) Pathogenesis of alcoholic fibrosis and cirrhosis in the baboon. Am J Pathol 98 (3):695–715Google Scholar
- Porto LC, Chevallier M, Grimaud J-A (1989) Morphometry of terminal hepatic veins in man and baboons. Virchows Arch [A] 414:129–134Google Scholar
- Rojkind M (1985) Collagen metabolism in the liver. In: Hall P (ed) Alcoholic Liver Disease. Edward Arnold, London, pp 91–112Google Scholar
- Scheuer PJ (1982) The morphology of alcoholic disease. Br Med Bull 38 (1):63–65Google Scholar
- Ugarte G, Iturriaga H (1976) Metabolic pathways of alcohol in the liver. Front Gastroenterol Res 2:150–193Google Scholar
- VanWaes L, Lieber CS (1977) Early perivenular fibrosis in alcoholic fatty liver: an index of progressive liver injury. Gastroenterology 73:646–650Google Scholar
- Worner T, Lieber CS (1985) Perivenular fibrosis as precursor lesion of cirrhosis. JAMA 254:627–630Google Scholar