Hepatic veno-occlusive lesions in severe alcoholic hepatitis and alcoholicliver cirrhosis: A comparative histopathological study in autopsy cases

Clinicopathological features of veno-occlusive lesions in hepatic veins wer e studied in autopsy cases of severe alcoholic hepatitis (15 cases) and alc oholic liver cirrhosis (15 cases). All the cases were heavy drinkers and di ed of liver failure or variceal rupture. The frequency and degree of veno-o cclusive lesions, and the diameter and number of hepatic veins were studied from stained sections of liver blocks from each case. The hepatic veins ob served ranged from 60 to 3000 mu m in diameter. The veno-occlusive lesions were found in hepatic veins mainly 60 to 1200 mu m in diameter. These findi ngs were recognized in the majority of severe alcoholic hepatitis cases and alcoholic liver cirrhosis cases. Furthermore, more severe veno-occlusive l esions were noted in severe alcoholic hepatitis, compared with alcoholic li ver cirrhosis. In the cases with obstruction in hepatic veins of >400 mu m, a decrease in the number of hepatic veins and zonal necrosis were noted. I n addition, some of the veno-occlusive lesions were recognized focally in t he same cases; Clinical findings also indicated that ascites increased with the progression of the veno-occlusive lesions. We conclude that investigat ion of veno-occlusive lesions in severe alcoholic liver disease has clinico pathological significance.