PATHOGENESIS OF VENO-OCCLUSIVE LIVER-DISEASE AFTER RADIATION

  • 1 January 1980
    • journal article
    • research article
    • Vol. 104  (11) , 584-588
Abstract
Radiation-induced liver disease is characterized structurally by progressive fibrous obliteration of central veins (venoocclusive disease [VOD]). The pathogenesis is unknown. Samples of liver from 11 patients with radiation-induced VOD were studied by light microscopy and EM for central vein thrombosis. The patients had received fractionated radiation with total doses of 1850-4050 rads or single doses of 1000 rads. Six patients had received chemotherapy. Although usually undetectable by light microscopy, fibrin was found in all samples, sometimes in large amounts, within central veins and often in the adjacent sinusoids. One sample had a small platelet aggregate. In 2 patients the portal veins showed occlusive lesions. Ionizing radiation apparently preferentially injures the endothelial cells of central veins, which leads to focal deposition of fibrin. The resulting fibrin network is eventually replaced by collagen, causing fibrous occlusion. In several patients this type of liver injury occurred at radiation doses conventionally considered safe even in the absence of chemotherapy.