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Journal of Clinical & Experimental Pathology
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  • Short Communication   
  • J Clin Exp Pathol 2015, Vol 5(4): 233
  • DOI: 10.4172/2161-0681.1000233

Granulomatous Phlebitis of the Hepatic Vein Tributaries after Portal Venous Embolization

Atsushi Kohga1, Yuko Kakuda2, Teiichi Sugiura1, Yukiyasu Okamura1, Takaaki Ito1, Yusuke Yamamoto1, Ryo Ashida1, Sunao Uemura1, Takashi Miyata1, Takeshi Aramaki3, Katsuhiko Uesaka1 and Yasuni Nakanuma2*
1Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan
2Division of Diagnostic Pathology, Shizuoka Cancer Center, Shizuoka, Japan
3Division of Interventional Radiology, Shizuoka Cancer Center, Shizuoka, Japan
*Corresponding Author : Yasuni Nakanuma MD, Division of Pathology, Shizuoka Cancer Center, 1007, Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka 4118777, Japan, Tel: +81-55-989-5222, Fax: +81-55-989-5783, Email: [email protected]

Received Date: May 15, 2015 / Accepted Date: Jun 11, 2015 / Published Date: Jun 14, 2015


Background & Aims: Granulomatous phlebitis of hepatic vein is a rare disease and its exact etiopathogenesis remains unknown. Recently, we experienced granulomatous phlebitis of small hepatic veins in a patient who underwent hepatic resection for metastatic liver cancer after preoperative portal venous embolization (PVE).

Methods: We surveyed such phlebitis in the patients who underwent PVE (2008 August – 2014 August). A total of 62 patients underwent PVE followed by hepatectomy for hepatocellular carcinoma (HCC), peripheral cholangicarcinoma (pCCA), or metastatic liver tumor (MLT) during this period. As a control, 20 cases of surgically resected livers without a history of preoperative PVE for liver tumors of comparable age and sex distribution in recent 2 years in the same hospital, were used.

Results: Granulomatous phlebitis of small hepatic veins was found in 10 patients with a history of PVE (16.1% of 62 cases) but not in control cases. No microbial agents were identified in these granulomatous lesions. Interestingly, the presence of embolic materials containing sponge gel with inflammation and foreign body reaction in the portal veins in the embolized livers were independently associated with granulomatous phlebitis.

Conclusions: It was suggested that sponge gel used for PVE might have be directly or indirectly related to the occurrence of granulomatous phlebitis. This is the first report of granulomatous phlebitis related to PVE.

Keywords: Preoperative portal venous embolism; Granulomatous phlebitis; Sponge gel; Foreign body reaction; Budd-Chiari syndrome; Hepatic vein.

Citation: Kohga A, Kakuda Y, Sugiura T, Okamura Y, Ito T et al. (2015) Granulomatous Phlebitis of the Hepatic Vein Tributaries after Portal Venous Embolization. J Clin Exp Pathol 5:233. Doi: 10.4172/2161-0681.1000233

Copyright: © 2015 Nakanuma Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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