Liver histopathology in patients with hepatic masses and the Abernethy malformation

Caroline Lemoine, Annika Nilsen, Katherine Brandt, Saeed Mohammad, Hector Melin-Aldana, Riccardo A Superina*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background/Purpose: The Abernethy malformation (AM) is a congenital venous malformation in which the splanchnic venous return bypasses the liver and drains directly into the systemic circulation. This deprives the liver of hepatotrophic growth factors and allows metabolic products of digestion to enter the systemic veins without the benefit of passing through the liver. The histologic features of liver biopsies in children with an AM were reviewed. Methods: A retrospective review of liver biopsies in patients with AM between 1997 and 2017 was performed. Patients were divided into two groups for comparison of histologic features: presence (M +) or absence (M −) of a coexistent liver mass on imaging. Biopsies were reviewed by a pediatric pathologist. Chi-square test was used for statistical analysis between groups. Significance was assigned to p values < 0.05. Results: Eighteen liver biopsies were reviewed. Masses were present in only 6 patients who had a liver biopsy. Masses were observed with similar frequencies in either type of the Abernethy malformation (I or II). Nine of 12 M − patients and 3/6 M + patients had the type I AM. Histologically, all patients were noted to have small or absent portal veins. Isolated capillaries were seen more frequently in patients with a known liver mass (p = 0.045), while crowding of portal tracts was more commonly seen in patients without a liver mass (p = 0.019). Conclusion: Liver biopsies in patients with AM demonstrate abnormal vascular and parenchymal histologic features. Livers with coexistent masses were more commonly found to have features suggesting an increased dependence on arterial blood supply. Level of evidence: III.

Original languageEnglish (US)
Pages (from-to)266-271
Number of pages6
JournalJournal of pediatric surgery
Volume54
Issue number2
DOIs
StatePublished - Feb 1 2019

Fingerprint

Liver
Biopsy
Viscera
Chi-Square Distribution
Portal Vein
Blood Vessels
Digestion
Veins
Pediatrics

Keywords

  • Abernethy malformation
  • Liver histology
  • Liver mass

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

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title = "Liver histopathology in patients with hepatic masses and the Abernethy malformation",
abstract = "Background/Purpose: The Abernethy malformation (AM) is a congenital venous malformation in which the splanchnic venous return bypasses the liver and drains directly into the systemic circulation. This deprives the liver of hepatotrophic growth factors and allows metabolic products of digestion to enter the systemic veins without the benefit of passing through the liver. The histologic features of liver biopsies in children with an AM were reviewed. Methods: A retrospective review of liver biopsies in patients with AM between 1997 and 2017 was performed. Patients were divided into two groups for comparison of histologic features: presence (M +) or absence (M −) of a coexistent liver mass on imaging. Biopsies were reviewed by a pediatric pathologist. Chi-square test was used for statistical analysis between groups. Significance was assigned to p values < 0.05. Results: Eighteen liver biopsies were reviewed. Masses were present in only 6 patients who had a liver biopsy. Masses were observed with similar frequencies in either type of the Abernethy malformation (I or II). Nine of 12 M − patients and 3/6 M + patients had the type I AM. Histologically, all patients were noted to have small or absent portal veins. Isolated capillaries were seen more frequently in patients with a known liver mass (p = 0.045), while crowding of portal tracts was more commonly seen in patients without a liver mass (p = 0.019). Conclusion: Liver biopsies in patients with AM demonstrate abnormal vascular and parenchymal histologic features. Livers with coexistent masses were more commonly found to have features suggesting an increased dependence on arterial blood supply. Level of evidence: III.",
keywords = "Abernethy malformation, Liver histology, Liver mass",
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Liver histopathology in patients with hepatic masses and the Abernethy malformation. / Lemoine, Caroline; Nilsen, Annika; Brandt, Katherine; Mohammad, Saeed; Melin-Aldana, Hector; Superina, Riccardo A.

In: Journal of pediatric surgery, Vol. 54, No. 2, 01.02.2019, p. 266-271.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Liver histopathology in patients with hepatic masses and the Abernethy malformation

AU - Lemoine, Caroline

AU - Nilsen, Annika

AU - Brandt, Katherine

AU - Mohammad, Saeed

AU - Melin-Aldana, Hector

AU - Superina, Riccardo A

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Background/Purpose: The Abernethy malformation (AM) is a congenital venous malformation in which the splanchnic venous return bypasses the liver and drains directly into the systemic circulation. This deprives the liver of hepatotrophic growth factors and allows metabolic products of digestion to enter the systemic veins without the benefit of passing through the liver. The histologic features of liver biopsies in children with an AM were reviewed. Methods: A retrospective review of liver biopsies in patients with AM between 1997 and 2017 was performed. Patients were divided into two groups for comparison of histologic features: presence (M +) or absence (M −) of a coexistent liver mass on imaging. Biopsies were reviewed by a pediatric pathologist. Chi-square test was used for statistical analysis between groups. Significance was assigned to p values < 0.05. Results: Eighteen liver biopsies were reviewed. Masses were present in only 6 patients who had a liver biopsy. Masses were observed with similar frequencies in either type of the Abernethy malformation (I or II). Nine of 12 M − patients and 3/6 M + patients had the type I AM. Histologically, all patients were noted to have small or absent portal veins. Isolated capillaries were seen more frequently in patients with a known liver mass (p = 0.045), while crowding of portal tracts was more commonly seen in patients without a liver mass (p = 0.019). Conclusion: Liver biopsies in patients with AM demonstrate abnormal vascular and parenchymal histologic features. Livers with coexistent masses were more commonly found to have features suggesting an increased dependence on arterial blood supply. Level of evidence: III.

AB - Background/Purpose: The Abernethy malformation (AM) is a congenital venous malformation in which the splanchnic venous return bypasses the liver and drains directly into the systemic circulation. This deprives the liver of hepatotrophic growth factors and allows metabolic products of digestion to enter the systemic veins without the benefit of passing through the liver. The histologic features of liver biopsies in children with an AM were reviewed. Methods: A retrospective review of liver biopsies in patients with AM between 1997 and 2017 was performed. Patients were divided into two groups for comparison of histologic features: presence (M +) or absence (M −) of a coexistent liver mass on imaging. Biopsies were reviewed by a pediatric pathologist. Chi-square test was used for statistical analysis between groups. Significance was assigned to p values < 0.05. Results: Eighteen liver biopsies were reviewed. Masses were present in only 6 patients who had a liver biopsy. Masses were observed with similar frequencies in either type of the Abernethy malformation (I or II). Nine of 12 M − patients and 3/6 M + patients had the type I AM. Histologically, all patients were noted to have small or absent portal veins. Isolated capillaries were seen more frequently in patients with a known liver mass (p = 0.045), while crowding of portal tracts was more commonly seen in patients without a liver mass (p = 0.019). Conclusion: Liver biopsies in patients with AM demonstrate abnormal vascular and parenchymal histologic features. Livers with coexistent masses were more commonly found to have features suggesting an increased dependence on arterial blood supply. Level of evidence: III.

KW - Abernethy malformation

KW - Liver histology

KW - Liver mass

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JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

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