Isolated hepatic non-obstructive sinusoidal dilatation, 20-year single center experience

Area of Science:

• Hepatology
• Pathology
• Vascular Biology

Background:

• Sinusoidal dilatation (SD) is a histological finding in liver biopsies.
• Non-obstructive SD can be challenging to differentiate from other causes of liver disease.
• Understanding associated conditions is key for accurate diagnosis.

Purpose of the Study:

• To characterize isolated non-obstructive sinusoidal dilatation (SD).
• To identify associated conditions, laboratory findings, and histological patterns.
• To differentiate SD from obstructive causes and congestive hepatopathy.

Main Methods:

• Retrospective review of 491 patients with SD (1995-2015).
• Exclusion of patients with obstruction, cirrhosis, malignancy, or transplant.
• Detailed liver histology review for SD extent, fibrosis, and other specific findings.

Main Results:

• Identified 88 patients with non-obstructive SD; inflammatory conditions were the most common cause (32%).
• Cholestatic pattern (76%) and Zone III localization (78%) were most frequent.
• Medication-related SD showed higher rates of portal hypertension, ascites, and elevated liver enzymes.

Conclusions:

• A significant proportion of SD and hepatocellular plate atrophy (HPA) occur without impaired hepatic venous outflow.
• Isolated SD on liver biopsy, without congestive hepatopathy, warrants further investigation.
• Portal hypertension should be ruled out in cases of isolated SD.