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Updated: Mar 25, 2026

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A Standardized Method for the Analysis of Liver Sinusoidal Endothelial Cells and Their Fenestrations by Scanning Electron Microscopy
Published on: April 30, 2015
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Sinusoidal obstruction syndrome (SOS): A light and electron microscopy study in human liver
C P H Vreuls1, A Driessen2, S W M Olde Damink3
1Department of Pathology, Maastricht University Medical Centre, Maastricht, The Netherlands; Department of Pathology, Amphia Hospital, Breda, The Netherlands.
Summary
Oxaliplatin-induced sinusoidal obstruction syndrome (SOS) in humans involves endothelial cell detachment. This study confirms findings from rat models in human liver biopsies, detailing key pathological features.
Area of Science:
- Hepatology
- Oncology
- Pathology
Background:
- Oxaliplatin is a key chemotherapy for colorectal liver metastases.
- Oxaliplatin is known to cause sinusoidal obstruction syndrome (SOS).
- Current understanding of SOS pathophysiology relies on animal models.
Purpose of the Study:
- To comprehensively investigate the features of human sinusoidal obstruction syndrome (SOS).
- To utilize both light microscopy (LM) and electron microscopy (EM) for detailed analysis.
- To compare human SOS findings with existing data from rat models.
Main Methods:
- Analysis of wedge liver biopsies from patients undergoing partial hepatectomy for colorectal liver metastases.
- Perfusion fixation and processing of biopsies for LM and EM.
- Selection and detailed EM study of SOS lesions in 30 patients (28 treated with oxaliplatin).
Main Results:
- SOS lesions were identified in 64% (18/28) of oxaliplatin-treated patients.
- Microscopic findings revealed sinusoidal endothelial cell detachment from the space of Disse.
- Enlargement of the space of Disse with erythrocyte presence was observed via EM.
Conclusions:
- Human SOS is characterized by sinusoidal endothelial cell detachment.
- The space of Disse is enlarged and contains erythrocytes in human SOS.
- These findings validate previous observations from rat models in a clinical context.
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