Summary
Five cases of peliosis hepatis diagnosed by peritoneoscopy (two confirmed by liver
biopsy) are presented. The patients were 4 males and one female, and their ages ranged
from 31 to 43 years. Each patient had had an episode of jaundice with fever in the
past. At peritoneoscopy, the lesions appeared as reddish-purple spots measuring up
to 2.0 mm in diameter. These spots did not show protrusion or retraction, and had
no clear relationship with the lobular markings formed by portal triads. In one case,
spots were connected to form irregular meshworks in places. In other cases, spots
were round or oblong.
Histologically, a spot obtained with a punch biopsy forceps had dilated sinusoids
filled with red blood cells. Similar dilated sinusoids were observed in deep tissues
of the liver obtained with a Vim-Silverman needle. Reconstruction studies of a liver
biopsy specimen proved that peliosis lesions were collections of dilated sinusoids.
The lesions formed ellipsoids with an irregular margin and were located in the central
and intermediate zones of a liver lobule. Other histological features of the liver,
mainly observed in the central area were: central fibrosis, fatty metamorphosis, slight
liver cell necrosis, and cholestasis. Peliosis hepatis in cases with acute hepatitis
and chronic alcoholic liver injury as in the present series is a new finding. The
lesion was also seen in a case of primary liver cancer.
Key words:
Peliosis hepatis - Dilated sinusoids - Peritoneoscopy - Liver biopsy - Reconstruction
study
