Isolated hepatic non-obstructive sinusoidal dilatation, 20-year single center experience

Table 1 Study demographics n (%)

Variables	n = 88
Age	56 (6-85)
Gender
Female	48 (54.5)
Ethnicity
Caucasian	75 (85.2)
Mortality within 1 yr	19 (21.6)
Portal hypertension	31 (35.2)
Radiological Findings
Hepatic nodule(s)	15 (17.0)
Splenomegaly	35 (39.8)
Ascites	29 (33.0)
Pattern of liver injury
Hepatocellular	8 (9.1)
Cholestatic	67 (76.1)
Mixed	9 (10.2)
Normal	4 (4.5)
Primary medical condition
Malignancy	21 (23.9)
Inflammatory disorder	28 (31.8)
Medication	19 (21.6)
Undefined	20 (22.7)

Table 2 Medical conditions associated with non-obstructive sinusoidal dilatation

Variables	n
Malignancy
Hematological malignancies
Leukemia
AML	2
CLL	1
CML	1
Lymphoma
B-cell lymphoma	4
T-cell lymphoma	1
Solid organ tumor
Gastric adenocarcinoma	2
Angiosarcoma	1
Myeloproliferative disorder	9
Inflammatory condition
Granulomatous hepatitis	4
Connective tissue disorder	3
Ulcerative colitis	2
Castleman’s disease	2
Polyarthritis nodosa	2
Other1	15
Medications
Oxaliplatin	7
Purine Analogs	3
Other2	9

¹Acute inflammatory demyelinating polyradiculopathy, autoimmune hepatitis, amyloidosis, CINCA syndrome, Crohn’s disease, IgA nephropathy, non-alcoholic steatohepatitis, primary biliary cirrhosis, psoriatic arthritis, and sarcoidosis;

²Alcohol, atorvastatin, allopurinol, cyclophosphamide, decitabine, ethinyl estradiol and norgestimate, vincristine, and ibritumomab tiuxetan. AML: Acute myelocytic leukemia; CLL: Chronic lymphoblastic cytic leukemia; CML: Chronic myelocytic leukemia.

Table 3 Clinical and radiological features stratified by conditions n (%)

	Malignancy (n = 21)	Inflammatory state (n = 28)	Medication (n = 19)	Not specified (n = 20)	P
Hepatic nodules	4 (19)	4 (14)	4 (21)	3 (15)	0.922
Portal hypertension	10 (48)	8 (29)	11 (58)	6 (30)	0.144
Ascites	7 (33)	5 (18)	11 (58)	6 (30)	0.04
Splenomegaly	9 (43)	11 (39)	9 (47)	6 (30)	0.719

Table 4 Laboratory findings stratified by conditions

	Malignancy	Inflammatory state	Medication	Not specified	P
AST (U/L)	46 (14-120)	43 (9-222)	113 (21-2351)	36 (14-80)	0.008
ALT (U/L)	36 (15-283)	46 (6-237)	90 (23-785)	28 (13-84)	0.002
Total bilirubin (mg/dL)	1.6 (0.3-28)	0.6 (0.2-9.1)	1.3 (0.4-12.8)	0.5 (0.3-8)	0.008
Direct bilirubin (mg/dL)	0.9 (0.1-24)	0.3 (0.1-6.2)	0.6 (0.1-8.2)	0.3 (0.1-5.8)	0.141
Alk Phosphotase (IU/L)	323 (71-1616)	355 (50-2288)	313 (104 - 1905)	135 (50-801)	0.057
GGT (U/L)	140 (82-1856)	106 (51-1066)	233 (50-418)	125 (N/A)	0.881
Albumin (g/L)	3.2 (1.7-4.3)	3.3 (2.1-4.1)	3.1 (2.5-4.5)	3.6 (1.2-4.3)	0.826
INR	1.2 (1-2.4)	1.1 (0.9-1.7)	1.1 (0.9-1.9)	1.1 (0.9-1.5)	0.106
Total protein (g/dL)	5.8 (1.6-9.2)	6.4 (4.7-8.6)	5.8 (4.8-8.2)	7.1 (5.2-10)	0.111
Platelets (103)	161 (25-907)	187 (10-708)	80 (17-339)	188 (78-352)	0.022
ESR (mm/h)	59 (3-132)	43 (0-121)	24 (13-117)	35 (6-127)	0.687

AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; GGT: Gamma-glutamyl transferase; ESR: Erythrocyte sedimentation rate.

Table 5 Pattern of liver injury stratified by conditions

	Malignancy	Inflammatory state	Medication	Not specified	P
Liver injury					0.536
Hepatocellular	1	2	4	1
Cholestasis	16	21	14	16
Mixed	3	4	1	1
Normal	1	1	0	2

Table 6 Histology features stratified by conditions

	Malignancy (n = 21)	Inflammatory state (n = 28)	Medications (n = 19)	Not specified (n = 20)	Total	P
Zone III II and III I, II, and III Other						0.82
	17 (81) 1 (5) 1 (5) 2 (10)	22 (79) 3 (11) 0 (0) 3 (11)	16 (84) 1 (5) 1 (5) 1 (5)	14 (70) 3 (15) 0 (0) 3 (15)	69 8 2 9
METAVIR score						0.60
0	15 (71) 3 (14) 1 (5) 0 (0)	14 (50) 6 (21) 4 (14) 1 (4)	13 (68) 3 (16) 1 (5) 2 (11)	9 (45) 5 (25) 3 (15) 2 (10)	51 17 9 5
1
2
3
Nodular regenerative hyperplasia	1(5)	2 (7)	4 (21)	2 (10)	9	0.33
Hepatic peliosis	1 (5)	0	0	0	1	0.36
Lymphocytic infiltration	6 (29)	8 (29)	6 (32)	4(20)	24	0.77
RBC extravasation	8 (38)	8 (29)	7 (37)	5 (25)	28	0.76
Hepatocellular plate atrophy	11 (52)	21 (75)	8 (42)	11 (55)	51	0.13