Primary Histologic Features of Veno-occlusive Disease

Loose, cellular intimal thickening: This elastic van Gieson stain shows a small vein that is narrowed by loose, cellular connective tissue. The multiple lumens suggest recanalization of thrombus, but may represent the same lumen in different planes of section. Note the congested capillaries.

Fibrotic intimal thickening: These two veins show dense fibrocellular intimal fibrosis, again with multiple lumens.

Fibrotic intimal thickening: An elastic van Gieson stain shows the dense fibrosis (red) of a narrowed venule.

Clinical summary Discussion

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Primary Histologic Features of Veno-occlusive Disease

Interlobular septal widening and centrilobular nodules: See the following two images for histologic correlations.

Interlobular septal widening: This widened, collagenized interlobular septum corresponds to a Kerley line on the radiograph.

Centrilobular nodules: The centrilobular nodules most likely represent the dilated capillaries with varying amounts of fibrosis. The larger foci of ground-glass opacity on the CTs may represent more confluent areas of dilated capillaries.

Clinical summary Discussion

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Primary Histologic Features of Veno-occlusive Disease

Venous arterialization: This medium-sized vein is arterialized. Instead of a single elastic layer, it has two or more. Also, the adventitia shows increased fibrous tissue.

Clinical summary Discussion

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Primary Histologic Features of Veno-occlusive Disease

Arterial thickening: Intimal thickening of muscular arteries, although not a constant finding, is probably a primary feature of the disease.

Clinical summary Discussion

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