Images in Clinical Medicine
Peliosis Hepatis
N Engl J Med 1997; 337:1603November 27, 1997
- Article
Figure 1 A 69-year-old woman was treated for aplastic anemia with a high dose of androgens (2 mg of methenolone acetate per kilogram of body weight) for nearly two years, with an initially good response. Two months before her death immunosuppressive therapy with cyclosporine and methylprednisolone was initiated. Apart from a slightly elevated serum bilirubin level (2 mg per deciliter [34.2 mmol per liter]) and elevated serum lactate dehydrogenase concentration (450 U per liter) attributed to hemolysis, there was no biochemical evidence of liver disease. The patient died of refractory anemia and thrombocytopenia. At autopsy the liver was enlarged (1600 g), with markedly reduced firmness. The cut surface of the liver showed multiple cavities, which were densely interspersed throughout the organ. The entire organ had the aspect of a sponge filled with blood (Panel A). The diameter of the cystic lesions ranged from less than 1 mm to 1 to 2 cm. The diffusely distributed lesions consisted of blood-filled, ectatic veins and some extremely dilated sinusoids. In some of the lesions the wall was fibrotic (Panel B; hematoxylin and eosin, ×200). Peliosis hepatis is a known complication of androgen therapy.
Eike Walter, M.D.
Medizinische UniversitätsklinikJochen Möckel, M.D.
Pathologisches Institut der Universität, 79106 Freiburg, Germany- Citing Articles (1)
Citing Articles
1
Michel I. Kafrouni, Robert A. Anders, Sumita Verma. (2007) Hepatotoxicity Associated With Dietary Supplements Containing Anabolic Steroids. Clinical Gastroenterology and Hepatology 5:7, 809-812
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