Liver, Portal vein thrombosis, trichrome stain [LMP51587]
Keywords
Portal vein thrombosis
Clinical History
27-year old female, jaundiced. Imaging shows portal hypertension. Suspicion of cirrhosis.
Clinical Discussion
Portal vein thrombosis is an important obstructive cause of portal hypertension and jaundice.
To answer the clinical question, cirrhosis is not present. First, the liver capsule shows smooth surfaces, and the fibrosis (better examined on trichrome stain, this slide) is not significant. In cases of non-cirrhotic portal hypertension, differential diagnoses include portal vein thrombosis, nodular regenerative hyperplasia, regressed cirrhosis and hepato-portal sclerosis.
Histological findings in portal vein thrombosis (PVT) may be patchy and finding an actual thrombosis is difficult. However, various vascular abnormalities are seen with congestion and dilated sinusoids. CD34 was helpful in this case, where CD34 highlights sinusoidal endothelialisation (not shown), also seen with portal vein thrombosis. CD34 does not normally stain the mature sinusoidal cells. PVT can also occur in the setting of a liver transplant.
This slide shows trichrome stain. See related content for H&E stain.
To answer the clinical question, cirrhosis is not present. First, the liver capsule shows smooth surfaces, and the fibrosis (better examined on trichrome stain, this slide) is not significant. In cases of non-cirrhotic portal hypertension, differential diagnoses include portal vein thrombosis, nodular regenerative hyperplasia, regressed cirrhosis and hepato-portal sclerosis.
Histological findings in portal vein thrombosis (PVT) may be patchy and finding an actual thrombosis is difficult. However, various vascular abnormalities are seen with congestion and dilated sinusoids. CD34 was helpful in this case, where CD34 highlights sinusoidal endothelialisation (not shown), also seen with portal vein thrombosis. CD34 does not normally stain the mature sinusoidal cells. PVT can also occur in the setting of a liver transplant.
This slide shows trichrome stain. See related content for H&E stain.
Related Content
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