Document Detail

Centrizonal arteries and microvessels in nonalcoholic steatohepatitis.
MedLine Citation:
PMID:  21836480     Owner:  NLM     Status:  MEDLINE    
Correct classification of nonalcoholic steatohepatitis (NASH) liver biopsies is of critical importance and relies on correct orientation to microscopic liver architecture. Centrizonal arteries can cause central zones to be mistaken for portal tracts, especially in the setting of centrizonal ductular reaction, and result in either missed diagnosis or inaccurate staging of NASH. A total of 100 randomly selected biopsies from NASH Clinical Research Network participants (February 2005 to August 2006, fibrosis stage >1a) were evaluated for arteries and CD34-positive microvessels in the centrizonal region. Prevalence of both centrizonal arteries and CD34-positive microvessels was graded as 0 (none in central zones), 1 (1 to 2 central zones with vessels), 2 (<50% of central zones with vessels), or 3 (≥50% of central zones with vessels). Centrizonal arteries and CD34-positive microvessels were present in 40 and 100 cases (40% and 100%), respectively. Arteries and CD34-positive microvessels were more commonly found in central zones in biopsies with greater degrees of fibrosis (62% with arteries in stage 3 to 4 versus 21% in stage 1 to 2 and 70% with microvessels in stage 3 to 4 versus 25% in stage 1 to 2), with increased prevalence of both centrizonal arteries and CD34-positive microvessels correlating directly with fibrosis stage (P<0.001). Ductular reaction was a common finding (55%) in patients with central zone arteries. The presence of centrizonal arteries must be recognized to allow for correct orientation to liver architecture in NASH and, together with the finding of increased CD34-positive microvessel formation in higher-stage fibrosis, suggests a possible association between neoangiogenesis and NASH progression to cirrhosis.
Ryan M Gill; Patricia Belt; Laura Wilson; Nathan M Bass; Linda D Ferrell
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The American journal of surgical pathology     Volume:  35     ISSN:  1532-0979     ISO Abbreviation:  Am. J. Surg. Pathol.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-15     Completed Date:  2011-10-07     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  7707904     Medline TA:  Am J Surg Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1400-4     Citation Subset:  IM    
Department of Pathology, University of California-San Francisco, 505 Parnassus Ave., San Francisco, CA, 94143-0102, USA.
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MeSH Terms
Antigens, CD34 / analysis
Arterioles / pathology
Bile Ducts, Intrahepatic / pathology
Chi-Square Distribution
Disease Progression
Fatty Liver / complications,  pathology*,  physiopathology
Liver / blood supply*
Liver Cirrhosis / etiology,  pathology
Microvessels / immunology,  pathology*,  physiopathology
Middle Aged
Neovascularization, Physiologic
Predictive Value of Tests
Severity of Illness Index
Young Adult
Grant Support
Reg. No./Substance:
0/Antigens, CD34

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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