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1.
Korean Journal of Pathology ; : 381-385, 2000.
Article in Korean | WPRIM | ID: wpr-18072

ABSTRACT

Hepatic veno-occlusive disease (VOD) is a rare disease due to occlusion of the terminal hepatic venules and/or sublobular veins, which is a result of endothelial damage from pyrrolizidine alkaloids in herbal teas, irradiation of the liver, or chemotherapy particularly in association with bone marrow transplantation. We recently experienced three cases of VOD developed after radiation therapy. Two cases occurred in hepatocellular carcinoma patients of a 37-year-old man with B viral chronic hepatitis and a 22-year-old man with B viral cirrhosis and the other in a 64-year-old patient with esophageal squamous cell carcinoma. For the treatment of hepatocellular carcinoma, chemoembolization with lipiodol and adriamycin, and external irradiation on the liver mass were done. The total radiation dose was 5400 cGy and 3000 cGy in each case. Five months and 3 months after irradiation, respectively, the resected liver masses showed extensive necrosis due to pre-operative treatment. To treat esophageal carcinoma, pre-operative concurrent chemotherapy of 5-FU and radiation of 4500 cGY were done. One month after irradiation, the radical esophgectomy and wedge biopsy of the liver were done. The liver of all 3 cases showed a dark red appearance with severe congestion in contrast to the pale brown normal liver, which was not included in the radiation field. On micoscopic examination, the terminal hepatic venules and sublobular veins showed subintimal edema, fibrin deposition, and partial or total luminal occlusion by loose fibrous tissue. The centrizonal sinusoids were markedly dilatated and congested with atrophy of hepatocytes.


Subject(s)
Adult , Humans , Middle Aged , Young Adult , Atrophy , Teas, Herbal , Biopsy , Bone Marrow Transplantation , Carcinoma, Hepatocellular , Carcinoma, Squamous Cell , Doxorubicin , Drug Therapy , Edema , Estrogens, Conjugated (USP) , Ethiodized Oil , Fibrin , Fibrosis , Fluorouracil , Hepatic Veno-Occlusive Disease , Hepatitis, Chronic , Hepatocytes , Liver , Necrosis , Phenobarbital , Pyrrolizidine Alkaloids , Rare Diseases , Veins , Venules
2.
The Korean Journal of Hepatology ; : 179-187, 1998.
Article in Korean | WPRIM | ID: wpr-144296

ABSTRACT

The clinical syndrome of venoocclusive disease of the liver is one of several manifestations of regimen-related toxicity that can occur after high-dose cytoreductive therapy. Hepatic dysfunction after bone marrow transplantation may result from a number of causes such as pretransplant chemoradiation, graft-versus host disease, drugs for prophylaxis of graft-versus host disease, venoocclusive disease, various infections, and infiltration of recurrent malignancy. The clinical distinction of these causes may be difficult and the treatment of each cause is also quite different. Therefore the diagnosis of veno-occlusive disease is important. Veno-occlusive disease affects zone 3 of the liver acinus and produces a syndrome of jaundice, painful hepatomegaly, and fluid retention. Veno-occlusive disease occurs in up to 50% of the patients who undergo BMT and is usually associated with a high mortality rate. In Korea, there are a few case reports on venoocclusive disease after BMT which were only confirmed by clinical symptoms. This is a first report of two cases of hepatic veno-occlusive disease after allogenic BMT, which were proven by laparoscopic liver biopsy in our country.


Subject(s)
Humans , Biopsy , Bone Marrow Transplantation , Bone Marrow , Diagnosis , Hepatic Veno-Occlusive Disease , Hepatomegaly , Jaundice , Korea , Leukemia , Liver , Mortality
3.
The Korean Journal of Hepatology ; : 179-187, 1998.
Article in Korean | WPRIM | ID: wpr-144289

ABSTRACT

The clinical syndrome of venoocclusive disease of the liver is one of several manifestations of regimen-related toxicity that can occur after high-dose cytoreductive therapy. Hepatic dysfunction after bone marrow transplantation may result from a number of causes such as pretransplant chemoradiation, graft-versus host disease, drugs for prophylaxis of graft-versus host disease, venoocclusive disease, various infections, and infiltration of recurrent malignancy. The clinical distinction of these causes may be difficult and the treatment of each cause is also quite different. Therefore the diagnosis of veno-occlusive disease is important. Veno-occlusive disease affects zone 3 of the liver acinus and produces a syndrome of jaundice, painful hepatomegaly, and fluid retention. Veno-occlusive disease occurs in up to 50% of the patients who undergo BMT and is usually associated with a high mortality rate. In Korea, there are a few case reports on venoocclusive disease after BMT which were only confirmed by clinical symptoms. This is a first report of two cases of hepatic veno-occlusive disease after allogenic BMT, which were proven by laparoscopic liver biopsy in our country.


Subject(s)
Humans , Biopsy , Bone Marrow Transplantation , Bone Marrow , Diagnosis , Hepatic Veno-Occlusive Disease , Hepatomegaly , Jaundice , Korea , Leukemia , Liver , Mortality
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