Bridging necrosis and reticulin bridging fibrosis induced by intrahepatic involvement of acute biphenotypic leukemia

A 47‐year‐old Japanese woman was diagnosed as having acute biphenotypic leukemia with association of t(9;22)(q34;q11). Cholestatic liver dysfunction arose, and she died of cachexia and intracranial hemorrhage. Autopsy showed unusual hepatic fibrosis. In the liver, bridging infiltration, bridging nec...

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Published in:APMIS : acta pathologica, microbiologica et immunologica Scandinavica microbiologica et immunologica Scandinavica, 2006-12, Vol.114 (12), p.908-911
Main Authors: KURODA, N., MIZOBUCHI, M., SHIMAMURA, Y., DAIBATA, M., MIYOSHI, I., OHARA, M., HIROUCHI, T., MIZUNO, K., LEE, G. H.
Format: Article
Language:English
Subjects:
Acute biphenotypic leukemia
Biological and medical sciences
Collagen - metabolism
collagen fiber
Fatal Outcome
Female
Fundamental and applied biological sciences. Psychology
Humans
Immunohistochemistry
Infectious diseases
Leukemia, Myeloid, Acute - metabolism
Leukemia, Myeloid, Acute - pathology
Liver Cirrhosis - metabolism
Liver Cirrhosis - pathology
liver fibrosis
Medical sciences
Microbiology
Middle Aged
Necrosis
Platelet-Derived Growth Factor - biosynthesis
Precursor Cell Lymphoblastic Leukemia-Lymphoma - metabolism
Precursor Cell Lymphoblastic Leukemia-Lymphoma - pathology
Proto-Oncogene Proteins c-sis
Reticulin - metabolism
reticulin fiber
Transforming Growth Factor beta1 - biosynthesis
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Summary:A 47‐year‐old Japanese woman was diagnosed as having acute biphenotypic leukemia with association of t(9;22)(q34;q11). Cholestatic liver dysfunction arose, and she died of cachexia and intracranial hemorrhage. Autopsy showed unusual hepatic fibrosis. In the liver, bridging infiltration, bridging necrosis and bridging fibrosis by leukemic cells were seen. It seemed that the degree of fibrosis was associated with the number of aggregates of infiltrating leukemic cells. The fibrotic foci were predominantly composed of reticulin and collagen fibers, and distortion of the lobules was observed. Immunohistochemically, dense bundles of alpha‐smooth muscle actin (ASMA)‐positive stromal cells, namely activated hepatic stellate cells (HSCs), were observed in the immature fibrotic foci as well as along the sinusoids densely infiltrated by leukemic cells. No cells positive for TGF‐β1 or PDGF‐BB were identified. In conclusion, extensive intrahepatic involvement by neoplastic cells in adult acute biphenotypic leukemia may cause the unusual “disorganized” hepatic fibrosis.
ISSN:0903-4641
1600-0463
DOI:10.1111/j.1600-0463.2006.apm_540.x