Slow cirrhosis--or no cirrhosis? a lesion causing benign intrahepatic portal hypertension

We report the histological findings in livers from a group of 60 patients with benign intrahepatic portal hypertension. The lesion is benign in comparison with true cirrhosis in the sense that most of the patients survive many years from the time of diagnosis. The histological changes, in our view, differ from those of any variant of cirrhosis and generally do not progress even after many years. The essential features are: (1) irregular capsular thickening; (2) thickening of some portal tracts with fine fibrous septa radiating out from some of them; and (3) distortion of lobular architecture with hyperplastic expansion of some areas and compression of others and irregularly distributed central veins. We suggest that this is the lesion responsible for at least some cases of so-called idiopathic non-cirrhotic portal hypertension.