Neoplastic angioendotheliomatosis with multifocal hemorrhagic necrosis of the liver

We describe an autopsy case of neoplastic angioendotheliomatosis with an emphasis on hepatic pathology. The neoplastic cells were found mainly in small vessels and capillaries throughout the body, especially in the lung, liver, and spleen. These cells showed immunophenotypes of B-cells indicating differentiation toward B-cells. The liver (1350 g) showed multiple hemorrhagic areas, especially in the subcapsular region. Microscopically, neoplastic cells were found in the dilated sinusoids, portal vein branches, and central and sublobular hepatic veins, and there was hemorrhage with hepatocytic necrosis and dropout, especially in centrilobular areas. Thromboemboli admixed with neoplastic cells were often found in portal veins and sublobular hepatic veins, which might have resulted in the multifocal hemorrhagic necrosis.