Nodular regenerative hyperplasia of the liver associated with idiopathic membranous glomerulonephritis

Nodular regenerative hyperplasia of the liver was found in a 67-yr-old man who had been suffering from nephrotic syndrome for years. Main clinical symptoms and signs were edema, proteinuria, hypertension, and abnormal studies of electrocardiogram. His renal disease had been relatively well controlled by administration of corticosteroids, but he died suddenly on March 12, 1986. Autopsy revealed fresh and old myocardial infarct and membranous glomerulonephritis. The liver weighed 1530 g and showed a diffuse nodular configuration except for in the area of Zahn's red infarct. Fibrosis was minimal in most areas, and each nodule was circumscribed by compressed atrophic parenchyma. However, this case was unusual compared to most cases of nodular regenerative hyperplasia because there was prominent fibrosis in the perihilar portion. Paucity of interlobular arterial branches was confirmed by a crude morphometry. We describe herein this somewhat unusual nodular regenerative hyperplasia case with some discussion concerning the histogenesis.