Peliosis hepatis. Report of two autopsy cases with a review of literature.

Two cases of peliosis hepatis, treated with a large dose of predonine for aplastic anemia and multiple myeloma, respectively, were reported. Case 1 showed no abnormal liver function, but, in Case 2 hepatomegaly, retention of ICG, and elevation of LDH level despite the normal serum transaminase were noted. In both cases, peliotic lesions were incidentally observed at autopsy. In Case 1, the lesion was localized in the right lobe only, but, in Case 2 the lesion was present throughout the entire lobes of the liver involving also a part of the spleen and bone marrow of the sternum. Innumerable blood-filled cavities were surrounded by incomplete reticulin or injured hepatocytes. In smaller lesions observed in Case 1, focal necrosis, hemorrhage, inflammation, and thrombi were prominent features. On the other hand, in extensive lesions, as in Case 2, a marked liver cell dissociation with sequent irregular reticulin arrangement was present. Though the etiology and peliosis hepatis is still uncertain in these cases, it was assumed that a large dose of predonine might have some correlation to the occurrence.