Generalized venocentric lesions in the virus-associated hemophagocytic syndrome

Clinical and autopsy findings in a 41/2-year-old boy who had been healthy until the onset of virus-associated hemophagocytic syndrome are presented. In addition to findings previously reported in association with the syndrome, widely disseminated perivenular expansile nodules of bland necrosis were seen. These nodules were suggestive of vessel injury, with extravasation of vascular contents and focal destruction of normal elements. The morphologic similarities of these nodules to early lesions of pulmonary veno-occlusive disease are discussed.