| Chronic Passive Congestion
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Etiology
•Any disease that results in right heart failure can
cause chronic passive congestion of the liver.
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Pathogenesis
• Right heart failure results in delayed emptying of
the great veins and retention of blood primarily in the central veins of the liver.
• This results in dilatation of central veins and
pooling of blood in the sinusoids towards the center
of the liver lobule.,
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Epidemiology
•Common.
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General Gross Description
• Grossly, the liver is enlarged,
deep red and somewhat soft.
• The lesion can be palpated clinically by an enlarged
liver with characteristically rounded edges.
• On cut surface, the liver oozes a considerable amount
of blood.
• The contrast between the central congested sinusoidal
space the peripheral paler areas, often with some
evidence of fatty change, results in a striking
appearance referred to as a "nutmeg" liver, since it resembles a bisected nutmeg.
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General Microscopic Description
• The lesion is characterized by
distended central veins full of blood, and congestion
of sinusoids in the centrilobular area.
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Clinical Correlation
• Aside from the enlargement of the liver, chronic
passive congestion has no clinical significance.
• If the lesion develops acutely with centri-lobular
necrosis, some evidence of liver cell death in the
form of elevated transaminases may be seen.
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References
• Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 872-873.
• Harrison's Principles of Internal Medicine, 13th Ed: Isselbach et. al. (eds). New York, McGraw-Hill, 1994, pp. 1489.
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| Chronic Passive Congestion
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| Synopsis by: T.V.Rajan, M.D., Ph.D. (T56000M36142)[487]
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