Changes in lymph vessels and portal veins in the portal... : Hepatology (original) (raw)

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Changes in lymph vessels and portal veins in the portal tract of patients with idiopathic portal hypertension: A morphometric study

Oikawa, Hiroki1; Masuda, Tomoyuki M.D.*, 1; Sato, Shin-Ichiro1; Yashima, Akiko1; Suzuki, Kazuyuki2; Sato, Shunichi2; Satodate, Ryoichi1

1Department of Pathology, School of Medicine, Iwate Medical University, Morioka, Japan

2Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Japan

*Address reprint requests to: Department of Pathology, School of Medicine, Iwate Medical University, Uchimaru 19-1, 020-8505 Morioka, Japan. Fax: 81-19-629-9340.

Received September 08, 1997; Accepted February 17, 1998; previously published online December 30, 2003

Abstract

Little is known about the effects of the pathological process associated with idiopathic portal hypertension (IPH) on hepatic lymph vessels or lymph flow. We used morphometric analysis to examine IPH-associated changes in lymph vessels and branches of the portal vein, with use of immunohistochemical staining for alpha smooth muscle actin. We also quantitated these changes using an image analysis system. The study was conducted with use of liver wedge biopsy material from 10 patients with advanced IPH and 10 control samples from patients with gastric carcinoma without liver disease. The number of lymph vessels, identified by a lack of smooth muscle layer in the wall, and the ratio of the total area of these vessels to that of the portal tract were higher in IPH samples than in the control samples, but the ratio of the area of a single lymph vessel to that of the portal tract in IPH samples was not different from control samples. The number of portal vein branches, characterized by hypertrophy of the smooth muscle layer in IPH samples was not different from control samples. The ratio of the total area of these branches to that of the portal tract, and the ratio of a single portal vein branch to that of the portal tract, were lower in IPH samples than in the control samples. Our results suggest that these morphometric changes in IPH may be associated with a reduction in portal blood flow and increased lymph flow, and that the latter may in turn reduce the high portal vein pressure in idiopathic portal hypertension.