Liver pathology of idiopathic portal hypertension. Comparison with non-cirrhotic portal fibrosis of India The Japan idiopathic portal hypertension study*+

Authors

  • Kunio Okuda,

    Corresponding author
    1. Ist Department of Medicine, Chiba University School of Medicine, Chiba; Department of Pathology, Kurume University School of Medicine, Kurume; Department of Pathology, Kitasato University School of Medicine, Sagamihara; Department of Surgery, Juntendo University School of Medicine, Tokyo; Department of Medicine, Jikei Medical College, Tokyo; 2nd Department of Surgery, Kyushy University School of Medicine, Fukuoka, Japan; and Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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  • Toshiro Nakashima,

    1. Ist Department of Medicine, Chiba University School of Medicine, Chiba; Department of Pathology, Kurume University School of Medicine, Kurume; Department of Pathology, Kitasato University School of Medicine, Sagamihara; Department of Surgery, Juntendo University School of Medicine, Tokyo; Department of Medicine, Jikei Medical College, Tokyo; 2nd Department of Surgery, Kyushy University School of Medicine, Fukuoka, Japan; and Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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  • Masahiko Okudaira,

    1. Ist Department of Medicine, Chiba University School of Medicine, Chiba; Department of Pathology, Kurume University School of Medicine, Kurume; Department of Pathology, Kitasato University School of Medicine, Sagamihara; Department of Surgery, Juntendo University School of Medicine, Tokyo; Department of Medicine, Jikei Medical College, Tokyo; 2nd Department of Surgery, Kyushy University School of Medicine, Fukuoka, Japan; and Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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  • Masayoshi Kage,

    1. Ist Department of Medicine, Chiba University School of Medicine, Chiba; Department of Pathology, Kurume University School of Medicine, Kurume; Department of Pathology, Kitasato University School of Medicine, Sagamihara; Department of Surgery, Juntendo University School of Medicine, Tokyo; Department of Medicine, Jikei Medical College, Tokyo; 2nd Department of Surgery, Kyushy University School of Medicine, Fukuoka, Japan; and Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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  • Yoshifumi Aida,

    1. Ist Department of Medicine, Chiba University School of Medicine, Chiba; Department of Pathology, Kurume University School of Medicine, Kurume; Department of Pathology, Kitasato University School of Medicine, Sagamihara; Department of Surgery, Juntendo University School of Medicine, Tokyo; Department of Medicine, Jikei Medical College, Tokyo; 2nd Department of Surgery, Kyushy University School of Medicine, Fukuoka, Japan; and Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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  • Masao Omata,

    1. Ist Department of Medicine, Chiba University School of Medicine, Chiba; Department of Pathology, Kurume University School of Medicine, Kurume; Department of Pathology, Kitasato University School of Medicine, Sagamihara; Department of Surgery, Juntendo University School of Medicine, Tokyo; Department of Medicine, Jikei Medical College, Tokyo; 2nd Department of Surgery, Kyushy University School of Medicine, Fukuoka, Japan; and Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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  • Mitsuo Sugiura,

    1. Ist Department of Medicine, Chiba University School of Medicine, Chiba; Department of Pathology, Kurume University School of Medicine, Kurume; Department of Pathology, Kitasato University School of Medicine, Sagamihara; Department of Surgery, Juntendo University School of Medicine, Tokyo; Department of Medicine, Jikei Medical College, Tokyo; 2nd Department of Surgery, Kyushy University School of Medicine, Fukuoka, Japan; and Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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  • Haruo Kameda,

    1. Ist Department of Medicine, Chiba University School of Medicine, Chiba; Department of Pathology, Kurume University School of Medicine, Kurume; Department of Pathology, Kitasato University School of Medicine, Sagamihara; Department of Surgery, Juntendo University School of Medicine, Tokyo; Department of Medicine, Jikei Medical College, Tokyo; 2nd Department of Surgery, Kyushy University School of Medicine, Fukuoka, Japan; and Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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  • Kiyoshi Inokuchi,

    1. Ist Department of Medicine, Chiba University School of Medicine, Chiba; Department of Pathology, Kurume University School of Medicine, Kurume; Department of Pathology, Kitasato University School of Medicine, Sagamihara; Department of Surgery, Juntendo University School of Medicine, Tokyo; Department of Medicine, Jikei Medical College, Tokyo; 2nd Department of Surgery, Kyushy University School of Medicine, Fukuoka, Japan; and Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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  • S. R. Bhusnurmath,

    1. Ist Department of Medicine, Chiba University School of Medicine, Chiba; Department of Pathology, Kurume University School of Medicine, Kurume; Department of Pathology, Kitasato University School of Medicine, Sagamihara; Department of Surgery, Juntendo University School of Medicine, Tokyo; Department of Medicine, Jikei Medical College, Tokyo; 2nd Department of Surgery, Kyushy University School of Medicine, Fukuoka, Japan; and Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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  • B. A. Aikat

    1. Ist Department of Medicine, Chiba University School of Medicine, Chiba; Department of Pathology, Kurume University School of Medicine, Kurume; Department of Pathology, Kitasato University School of Medicine, Sagamihara; Department of Surgery, Juntendo University School of Medicine, Tokyo; Department of Medicine, Jikei Medical College, Tokyo; 2nd Department of Surgery, Kyushy University School of Medicine, Fukuoka, Japan; and Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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  • *

    The Idiopathic Portal Hypertension Study Group supported by the Japanese Ministry of Health and Welfare had the following participants: Chairman – K. Okuda (Chiba); Subcommittee Chairman – T. Nakashima (Kurume); Secretary – H. Musha (Chiba); Members – H. Kameda (Tokyo), M. Sugiura (Tokyo), K. Inokuchi (Fukuoka), S. Yamamoto (Nagoya), M. Okudaira (Sagamihara), T. Shikata (Tokyo), N. Nakata (Osaka), T. Hirashima (Chiba), K. Koyama (Sendai), Y. Takashashi (Tenri), S. Nakagawa (Kurashiki), T. Yasutomi (Kyoto), K. Kitani (Tokyo), S. Sawada (Nagoya), Y. Kobayashi (Ohita), K. Yoshida (Niigata), A. Ohkubo (Tokyo), S. Futagawa (Tokyo), T. Isomatsu (Sapporo), N. Matsuda (Tenri) and M. Ukita (Iwakuni).

  • +

    Portions of these data were presented at the 1980 Meeting of the International Association for the Study of the Liver, November 8, 1980, in Chicago, IL, and have been published in abstract form (1).

Department of Medicine Chiba University Hospital Chiba (280) Japan

Abstract

ABSTRACT— Morphological changes of the liver were studied in 24 autopsy cases of noncirrhotic portal hypertension of unknown etiology (idiopathic portal hypertension, IPH), and in 123 surgical biopsies from such patients. For comparison, 15 whole-cut liver slices from autopsy cases of noncirrhotic portal fibrosis (NCPF) from India were also studied. Liver pathology was very similar in IPH and NCPF, characterized by phlebosclerotic changes and perivascular fibrosis of the portal vein system, and parenchymal atrophy perhaps secondary to portal circulatory insufficiency. The distribution of lesions was uneven, and despite marked fibrosis and occasional surface nodularity, there was no diffuse pseudonodule formation in the parenchyma. Surgical specimens showed similar changes except for more frequent portal cellular infiltrates, but the changes seen in one biopsy specimen were limited and not always diagnostic. It seems that IPH of Japan and NCPF of India are the same disease, and perhaps hepatoportal sclerosis elsewhere is also the same disease.

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