Ultrastructure of sinusoids in patients with agnogenic myeloid metaplasia

Four patients with agnogenic myeloid metaplasia underwent liver biopsies. Under light microscopy, sinusoidal infiltration was very mild or moderate, liver architecture was normal with sinusoids slightly dilated and the perisinusoidal collagen network was increased. Under electron microscopy, in perfusion-fixed sinusoids, the following abnormalities were noticed. a) Presence of hemopoietic cells (erythroid, megakaryocytic, lymphoid, myeloid) at different stages of maturation. More frequently observed in the lumen than in the Disse space, they were usually isolated and never exceeded 2 or 3 cells. In the Disse space, hepatocytes in contact with hemopoietic cells were devoid of microvilli. In the lumen they were close to endothelial cells and Kupffer cells. Kupffer cells were numerous with intense phagocytic activity. b) Numerous collagen bundles encircling sinusoids. c) Transformation of perisinusoidal cells into transitional cells with few lipids, prominent RER, long and thick processes containing filaments sometimes condensed below the plasma membrane. Although only one patient showed clinical evidence of portal hypertension of sinusoidal origin, these results suggest that hepatic vascular resistance might be raised in agnogenic myeloid metaplasia.