Matsukuma Susumu, Takeo Hiroaki, Utsumi Yoshitaka, Sato Kimiya
Department of Pathology, Japan Self-Defense Forces Central Hospital, 1-2-24 Ikejiri, Setagaya-ku, Tokyo, 154-8532, Japan.
Health Care Center, Japan Self-Defense Forces Central Hospital, 1-2-24 Ikejiri, Setagaya-ku, Tokyo, 154-8532, Japan.
Virchows Arch. 2017 Apr;470(4):411-420. doi: 10.1007/s00428-017-2074-6. Epub 2017 Jan 23.
For hepatic venous outflow obstruction, alcoholic liver injury, and nonalcoholic fatty liver disease, the term "centrizonal injury disease" (CID) is used, because injury patterns in all three entities are similar. To elucidate CID-related CD34+ vessels (sinusoids and/or microvessels) and keratin 7+ hepatocytes (K7+ Hs), we examined a series of 41 liver tissue specimens obtained at autopsy and surgery, consisting of 32 CID cases and 9 controls. Centrizonal scars were found in 21 CID cases, and these were associated with centrizonal CD34+ vessels (P = 0.009) and centrizonal K7+ Hs (P < 0.001). Centrizonal coexistence of CD34+ vessels and K7+ Hs was observed in 22 CID cases (P = 0.057). These findings suggest close centrizonal proximity of scar, CD34+ vessels, and K7+ Hs in CID. However, centrizonal K7+ Hs without CD34+ vessels were observed in 21 CID cases. CD34+ vessels were detectable in all control samples and may represent the normal vascular bed. In 29 CID cases, centrizonal CD34+ vessel density was higher than that in controls. However, most appeared to be continuous with periportal and/or interlobular CD34+ vessels, and those CD34+ vessels restricted to centrizonal regions were focal and limited in seven CID cases. Centrizonal CD34+ vessels were associated with venoportal adhesions (P = 0.027). Our findings suggest that CID induces both venoportal adhesion-related structural distortion and expansion of normally present CD34+ vessels, which may result in increased centrizonal CD34+ vessel density.
对于肝静脉流出道梗阻、酒精性肝损伤和非酒精性脂肪性肝病,使用术语“中心性损伤疾病”(CID),因为这三种疾病的损伤模式相似。为了阐明与CID相关的CD34+血管(血窦和/或微血管)和角蛋白7+肝细胞(K7+H),我们检查了一系列41例尸检和手术获取的肝组织标本,其中包括32例CID病例和9例对照。在21例CID病例中发现了中心性瘢痕,这些瘢痕与中心性CD34+血管(P = 0.009)和中心性K7+H(P < 0.001)相关。在22例CID病例中观察到CD34+血管和K7+H在中心性区域共存(P = 0.057)。这些发现表明在CID中瘢痕、CD34+血管和K7+H在中心性区域紧密相邻。然而,在21例CID病例中观察到了没有CD34+血管的中心性K7+H。在所有对照样本中均可检测到CD34+血管,其可能代表正常血管床。在29例CID病例中,中心性CD34+血管密度高于对照。然而,大多数似乎与门周和/或小叶间CD34+血管连续,并且在7例CID病例中,局限于中心性区域的那些CD34+血管是局灶性且有限的。中心性CD34+血管与门静脉粘连相关(P = 0.027)。我们的发现表明,CID可导致门静脉粘连相关的结构扭曲以及正常存在的CD34+血管扩张,这可能导致中心性CD34+血管密度增加。