{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:14:58Z","timestamp":1779149698224,"version":"3.51.4"},"reference-count":36,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Context.<\/jats:italic>\n                    \u2014Impairment of venous outflow manifests as zone 3 sinusoidal dilatation and congestion (SDC) in liver biopsy. However, the finding of SDC is not specific for venous outflow impairment.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Objectives.<\/jats:italic>\n                    \u2014To determine the specificity of SDC in liver biopsies for venous outflow impairment and to seek an explanation for SDC in patients without clinical or radiologic features of venous outflow impairment.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Design.<\/jats:italic>\n                    \u2014Liver biopsies from 51 patients with sinusoidal dilatation were reviewed. Biopsies from transplant recipients, patients with cirrhosis, and patients with hepatic neoplasms (primary or metastatic) were not included. Clinical records were reviewed for laboratory tests and final clinicopathologic diagnosis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Results.<\/jats:italic>\n                    \u2014Thirty-four patients (66.7%) had confirmed venous outflow impairment. Of the 17 cases (33.3%) without clinical and\/or radiologic evidence of venous outflow impairment, vascular causes were present in 5 cases (9.8%; nodular regenerative hyperplasia in 2 cases and portal vein thrombosis, congenital absence of the portal vein, and sickle cell anemia in 1 case each). Systemic inflammatory disorders were identified in 6 patients (11.8%). These included 2 cases of Castleman disease and 1 each of sarcoidosis, Crohn disease, rheumatoid arthritis, and Still disease. Three patients (5.9%) had tumors without direct involvement of the liver (1 case each of Hodgkin lymphoma, renal cell carcinoma, and pancreatic serous pseudopapillary tumor). In the remaining 3 patients, SDC was identified in wedge liver biopsies performed at the time of surgery, including gastric bypass surgery, cholecystectomy, and splenectomy. No other disease association was apparent in these cases.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusion.<\/jats:italic>\n                    \u2014Sinusoidal dilatation and congestion in liver biopsy is associated with venous outflow impairment in two thirds of the cases. In the absence of clinical and\/or radiological evidence of venous outflow, diagnostic considerations include other vascular conditions, such as portal vein insufficiency and nodular regenerative hyperplasia. Sinusoidal dilatation and congestion can also occur in the setting of systemic inflammatory diseases, granulomatous disorders, and neoplasms, as well as in wedge biopsies obtained during abdominal surgery.\n                  <\/jats:p>","DOI":"10.5858\/2004-128-901-sdacil","type":"journal-article","created":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T20:09:12Z","timestamp":1612987752000},"page":"901-904","source":"Crossref","is-referenced-by-count":87,"title":["Sinusoidal Dilatation and Congestion in Liver Biopsy: Is It Always Due to Venous Outflow Impairment?"],"prefix":"10.5858","volume":"128","author":[{"given":"Sanjay","family":"Kakar","sequence":"first","affiliation":[{"name":"From the Department of Pathology, Veteran Affairs and University of California Medical Center, San Francisco, Calif (Dr Kakar); and the Departments of Gastroenterology (Dr Kamath) and Pathology (Dr Burgart), Mayo Clinic, Rochester, Minn"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick S.","family":"Kamath","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, Veteran Affairs and University of California Medical Center, San Francisco, Calif (Dr Kakar); and the Departments of Gastroenterology (Dr Kamath) and Pathology (Dr Burgart), Mayo Clinic, Rochester, Minn"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence J.","family":"Burgart","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, Veteran Affairs and University of California Medical Center, San Francisco, Calif (Dr Kakar); and the Departments of Gastroenterology (Dr Kamath) and Pathology (Dr Burgart), Mayo Clinic, Rochester, Minn"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3906","reference":[{"key":"i1543-2165-128-8-901-b1","series-title":"Hepatology","first-page":"488","article-title":"Pathology of the liver in Budd-Chiari syndrome: portal vein thrombosis and the histogenesis of veno-centric cirrhosis, veno-portal cirrhosis, and large regenerative nodules.","volume":"27","author":"Tanaka, M.","year":"1998","unstructured":"Tanaka, M. and I. R.Wanless. Pathology of the liver in Budd-Chiari syndrome: portal vein thrombosis and the histogenesis of veno-centric cirrhosis, veno-portal cirrhosis, and large regenerative nodules.Hepatology1998. 27:488\u2013496."},{"key":"i1543-2165-128-8-901-b2","series-title":"Hepatogastroenterology","first-page":"2359","article-title":"Clinical features, image analysis, and laparoscopic and histological liver findings in Budd-Chiari syndrome.","volume":"45","author":"Iwai, M.","year":"1998","unstructured":"Iwai, M., Y.Kitagawa, and T.Nakajima. et al. Clinical features, image analysis, and laparoscopic and histological liver findings in Budd-Chiari syndrome.Hepatogastroenterology1998. 45:2359\u20132368."},{"key":"i1543-2165-128-8-901-b3","series-title":"Gastroenterology","first-page":"2081","article-title":"Histopathology of membranous obstruction of the inferior vena cava in the Budd-Chiari syndrome.","volume":"102","author":"Kage, M.","year":"1992","unstructured":"Kage, M., M.Arakawa, M.Kojiro, and K.Okuda. Histopathology of membranous obstruction of the inferior vena cava in the Budd-Chiari syndrome.Gastroenterology1992. 102:2081\u20132090."},{"key":"i1543-2165-128-8-901-b4","series-title":"Semin Liver Dis","first-page":"5","article-title":"Hepatic vein thrombosis (Budd-Chiari syndrome).","volume":"22","author":"Valla, D. C.","year":"2002","unstructured":"Valla, D. C.\n          \n          Hepatic vein thrombosis (Budd-Chiari syndrome).\n          Semin Liver Dis\n          2002. 22:5\u201314."},{"key":"i1543-2165-128-8-901-b5","series-title":"Medicine (Baltimore)","first-page":"21","article-title":"Hepatic outflow obstruction (Budd-Chiari syndrome): experience with 177 patients and a review of the literature.","volume":"73","author":"Dilawari, J. B.","year":"1994","unstructured":"Dilawari, J. B., P.Bambery, and Y.Chawla. et al. Hepatic outflow obstruction (Budd-Chiari syndrome): experience with 177 patients and a review of the literature.Medicine (Baltimore)1994. 73:21\u201336."},{"key":"i1543-2165-128-8-901-b6","series-title":"Am Heart J","first-page":"111","article-title":"Heart diseases affecting the liver and liver diseases affecting the heart.","volume":"140","author":"Naschitz, J. E.","year":"2000","unstructured":"Naschitz, J. E., G.Slobodin, R. J.Lewis, E.Zuckerman, and D.Yeshurun. Heart diseases affecting the liver and liver diseases affecting the heart.Am Heart J2000. 140:111\u2013120."},{"key":"i1543-2165-128-8-901-b7","series-title":"Am J Med","first-page":"833","article-title":"The liver in sickle cell disease: a clinicopathologic study of 70 patients.","volume":"69","author":"Bauer, T. W.","year":"1980","unstructured":"Bauer, T. W., G. W.Moore, and G. M.Hutchins. The liver in sickle cell disease: a clinicopathologic study of 70 patients.Am J Med1980. 69:833\u2013837."},{"key":"i1543-2165-128-8-901-b8","series-title":"Arch Pathol Lab Med","first-page":"290","article-title":"Histopathologic features of liver biopsy specimens in sickle cell disease.","volume":"112","author":"Mills, L. R.","year":"1988","unstructured":"Mills, L. R., D.Mwakyusa, and P. F.Milner. Histopathologic features of liver biopsy specimens in sickle cell disease.Arch Pathol Lab Med1988. 112:290\u2013294."},{"key":"i1543-2165-128-8-901-b9","series-title":"Gastroenterology","first-page":"474","article-title":"Incidence and clinical significance of sinusoidal dilatation in liver biopsies.","volume":"75","author":"Bruguera, M.","year":"1978","unstructured":"Bruguera, M., F.Aranguibel, E.Ros, and J.Rodes. Incidence and clinical significance of sinusoidal dilatation in liver biopsies.Gastroenterology1978. 75:474\u2013478."},{"key":"i1543-2165-128-8-901-b10","series-title":"Scand J Gastroenterol Suppl","first-page":"103","article-title":"The significance of centrilobular sinusoidal changes in liver biopsies.","volume":"7","author":"Poulsen, H.","year":"1970","unstructured":"Poulsen, H., K.Winkler, and P.Christoffersen. 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Hepatic sinusoidal dilatation associated to giant lymph node hyperplasia (Castleman's): a new case in a patient with periorbital xanthelasmas and history of celiac disease.J Clin Gastroenterol1998. 27:76\u201378."},{"key":"i1543-2165-128-8-901-b15","series-title":"Pathol Res Pract","first-page":"1159","article-title":"Hepatic lesions of vascular origin in multicentric Castleman's disease, plasma cell type: report of one case with peliosis hepatis and another with perisinusoidal fibrosis and nodular regenerative hyperplasia.","volume":"191","author":"Molina, T.","year":"1995","unstructured":"Molina, T., A.Delmer, and A.Le Tourneau. et al. Hepatic lesions of vascular origin in multicentric Castleman's disease, plasma cell type: report of one case with peliosis hepatis and another with perisinusoidal fibrosis and nodular regenerative hyperplasia.Pathol Res Pract1995. 191:1159\u20131164."},{"key":"i1543-2165-128-8-901-b16","series-title":"J Am Acad Dermatol","first-page":"105","article-title":"Reversible plane xanthoma, vasculitis, and peliosis hepatis in giant lymph node hyperplasia (Castleman's disease): a case report and review of the cutaneous manifestations of giant lymph node hyperplasia.","volume":"26","author":"Sherman, D.","year":"1992","unstructured":"Sherman, D., B.Ramsay, and N. A.Theodorou. et al. Reversible plane xanthoma, vasculitis, and peliosis hepatis in giant lymph node hyperplasia (Castleman's disease): a case report and review of the cutaneous manifestations of giant lymph node hyperplasia.J Am Acad Dermatol1992. 26:105\u2013109."},{"key":"i1543-2165-128-8-901-b17","series-title":"Hum Pathol","first-page":"1193","article-title":"Sinusoidal dilatation of the liver as a paraneoplastic manifestation of renal cell carcinoma.","volume":"20","author":"Aoyagi, T.","year":"1989","unstructured":"Aoyagi, T., I.Mori, Y.Ueyama, and N.Tamaoki. Sinusoidal dilatation of the liver as a paraneoplastic manifestation of renal cell carcinoma.Hum Pathol1989. 20:1193\u20131197."},{"key":"i1543-2165-128-8-901-b18","series-title":"Am J Gastroenterol","first-page":"239","article-title":"Hypernephroma with nonmetastatic liver dysfunction (Stauffer's syndrome) and hypercalcemia.","volume":"72","author":"Delpre, G.","year":"1979","unstructured":"Delpre, G., B.Ilie, J.Papo, C.Streifler, and A.Gefel. Hypernephroma with nonmetastatic liver dysfunction (Stauffer's syndrome) and hypercalcemia.Am J Gastroenterol1979. 72:239\u2013247."},{"key":"i1543-2165-128-8-901-b1","series-title":"Hepatology","first-page":"488","article-title":"Pathology of the liver in Budd-Chiari syndrome: portal vein thrombosis and the histogenesis of veno-centric cirrhosis, veno-portal cirrhosis, and large regenerative nodules.","volume":"27","author":"Tanaka, M.","year":"1998","unstructured":"Tanaka, M. and I. R.Wanless. Pathology of the liver in Budd-Chiari syndrome: portal vein thrombosis and the histogenesis of veno-centric cirrhosis, veno-portal cirrhosis, and large regenerative nodules.Hepatology1998. 27:488\u2013496."},{"key":"i1543-2165-128-8-901-b2","series-title":"Hepatogastroenterology","first-page":"2359","article-title":"Clinical features, image analysis, and laparoscopic and histological liver findings in Budd-Chiari syndrome.","volume":"45","author":"Iwai, M.","year":"1998","unstructured":"Iwai, M., Y.Kitagawa, and T.Nakajima. et al. Clinical features, image analysis, and laparoscopic and histological liver findings in Budd-Chiari syndrome.Hepatogastroenterology1998. 45:2359\u20132368."},{"key":"i1543-2165-128-8-901-b3","series-title":"Gastroenterology","first-page":"2081","article-title":"Histopathology of membranous obstruction of the inferior vena cava in the Budd-Chiari syndrome.","volume":"102","author":"Kage, M.","year":"1992","unstructured":"Kage, M., M.Arakawa, M.Kojiro, and K.Okuda. Histopathology of membranous obstruction of the inferior vena cava in the Budd-Chiari syndrome.Gastroenterology1992. 102:2081\u20132090."},{"key":"i1543-2165-128-8-901-b4","series-title":"Semin Liver Dis","first-page":"5","article-title":"Hepatic vein thrombosis (Budd-Chiari syndrome).","volume":"22","author":"Valla, D. C.","year":"2002","unstructured":"Valla, D. C.\n          \n          Hepatic vein thrombosis (Budd-Chiari syndrome).\n          Semin Liver Dis\n          2002. 22:5\u201314."},{"key":"i1543-2165-128-8-901-b5","series-title":"Medicine (Baltimore)","first-page":"21","article-title":"Hepatic outflow obstruction (Budd-Chiari syndrome): experience with 177 patients and a review of the literature.","volume":"73","author":"Dilawari, J. B.","year":"1994","unstructured":"Dilawari, J. B., P.Bambery, and Y.Chawla. et al. Hepatic outflow obstruction (Budd-Chiari syndrome): experience with 177 patients and a review of the literature.Medicine (Baltimore)1994. 73:21\u201336."},{"key":"i1543-2165-128-8-901-b6","series-title":"Am Heart J","first-page":"111","article-title":"Heart diseases affecting the liver and liver diseases affecting the heart.","volume":"140","author":"Naschitz, J. E.","year":"2000","unstructured":"Naschitz, J. E., G.Slobodin, R. J.Lewis, E.Zuckerman, and D.Yeshurun. Heart diseases affecting the liver and liver diseases affecting the heart.Am Heart J2000. 140:111\u2013120."},{"key":"i1543-2165-128-8-901-b7","series-title":"Am J Med","first-page":"833","article-title":"The liver in sickle cell disease: a clinicopathologic study of 70 patients.","volume":"69","author":"Bauer, T. W.","year":"1980","unstructured":"Bauer, T. W., G. W.Moore, and G. M.Hutchins. The liver in sickle cell disease: a clinicopathologic study of 70 patients.Am J Med1980. 69:833\u2013837."},{"key":"i1543-2165-128-8-901-b8","series-title":"Arch Pathol Lab Med","first-page":"290","article-title":"Histopathologic features of liver biopsy specimens in sickle cell disease.","volume":"112","author":"Mills, L. R.","year":"1988","unstructured":"Mills, L. R., D.Mwakyusa, and P. F.Milner. Histopathologic features of liver biopsy specimens in sickle cell disease.Arch Pathol Lab Med1988. 112:290\u2013294."},{"key":"i1543-2165-128-8-901-b9","series-title":"Gastroenterology","first-page":"474","article-title":"Incidence and clinical significance of sinusoidal dilatation in liver biopsies.","volume":"75","author":"Bruguera, M.","year":"1978","unstructured":"Bruguera, M., F.Aranguibel, E.Ros, and J.Rodes. Incidence and clinical significance of sinusoidal dilatation in liver biopsies.Gastroenterology1978. 75:474\u2013478."},{"key":"i1543-2165-128-8-901-b10","series-title":"Scand J Gastroenterol Suppl","first-page":"103","article-title":"The significance of centrilobular sinusoidal changes in liver biopsies.","volume":"7","author":"Poulsen, H.","year":"1970","unstructured":"Poulsen, H., K.Winkler, and P.Christoffersen. The significance of centrilobular sinusoidal changes in liver biopsies.Scand J Gastroenterol Suppl1970. 7:103\u2013109."},{"key":"i1543-2165-128-8-901-b11","series-title":"APMIS Suppl","first-page":"86","article-title":"A reappraisal of Poulsen's disease (hepatic zone 1 sinusoidal dilatation).","volume":"23","author":"Winkler, K.","year":"1991","unstructured":"Winkler, K. and P.Christoffersen. A reappraisal of Poulsen's disease (hepatic zone 1 sinusoidal dilatation).APMIS Suppl1991. 23:86\u201390."},{"key":"i1543-2165-128-8-901-b12","series-title":"Hepatology","first-page":"343","article-title":"Role of ischemia in causing apoptosis, atrophy, and nodular hyperplasia in human liver.","volume":"26","author":"Shimamatsu, K.","year":"1997","unstructured":"Shimamatsu, K. and I. R.Wanless. 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Hepatic sinusoidal dilatation associated to giant lymph node hyperplasia (Castleman's): a new case in a patient with periorbital xanthelasmas and history of celiac disease.J Clin Gastroenterol1998. 27:76\u201378."},{"key":"i1543-2165-128-8-901-b15","series-title":"Pathol Res Pract","first-page":"1159","article-title":"Hepatic lesions of vascular origin in multicentric Castleman's disease, plasma cell type: report of one case with peliosis hepatis and another with perisinusoidal fibrosis and nodular regenerative hyperplasia.","volume":"191","author":"Molina, T.","year":"1995","unstructured":"Molina, T., A.Delmer, and A.Le Tourneau. et al. Hepatic lesions of vascular origin in multicentric Castleman's disease, plasma cell type: report of one case with peliosis hepatis and another with perisinusoidal fibrosis and nodular regenerative hyperplasia.Pathol Res Pract1995. 191:1159\u20131164."},{"key":"i1543-2165-128-8-901-b16","series-title":"J Am Acad Dermatol","first-page":"105","article-title":"Reversible plane xanthoma, vasculitis, and peliosis hepatis in giant lymph node hyperplasia (Castleman's disease): a case report and review of the cutaneous manifestations of giant lymph node hyperplasia.","volume":"26","author":"Sherman, D.","year":"1992","unstructured":"Sherman, D., B.Ramsay, and N. A.Theodorou. et al. Reversible plane xanthoma, vasculitis, and peliosis hepatis in giant lymph node hyperplasia (Castleman's disease): a case report and review of the cutaneous manifestations of giant lymph node hyperplasia.J Am Acad Dermatol1992. 26:105\u2013109."},{"key":"i1543-2165-128-8-901-b17","series-title":"Hum Pathol","first-page":"1193","article-title":"Sinusoidal dilatation of the liver as a paraneoplastic manifestation of renal cell carcinoma.","volume":"20","author":"Aoyagi, T.","year":"1989","unstructured":"Aoyagi, T., I.Mori, Y.Ueyama, and N.Tamaoki. Sinusoidal dilatation of the liver as a paraneoplastic manifestation of renal cell carcinoma.Hum Pathol1989. 20:1193\u20131197."},{"key":"i1543-2165-128-8-901-b18","series-title":"Am J Gastroenterol","first-page":"239","article-title":"Hypernephroma with nonmetastatic liver dysfunction (Stauffer's syndrome) and hypercalcemia.","volume":"72","author":"Delpre, G.","year":"1979","unstructured":"Delpre, G., B.Ilie, J.Papo, C.Streifler, and A.Gefel. 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