1992 Volume 34 Issue 7 Pages 1631-1637
Peritoneoscopy was performed for a rare case of a 46-year-old male with systemic amyloidosis manifested portal hypertension. Peritoneoscopic findings showed numerous small and large depressions on the liver surface with splenomegaly and ascites. Magnifying peritoneoscopic examination revealed the whitish mesh-like depressions surrounding the slightly protruded areas and abnormal small vessels on the liver surface. The histological findings of the liver showed parenchymal cell necroses consistent with depressions on the liver surface. The portal tracts were enlarged, including many dilated portal veins and arteries. Deposits stained by Congo-red were observed only in the wall of the subcapslar arteries of the liver surface. The deposits were revealed as amyloid A protein (AA) by the immunohistochemical method. The pattern of deposition was different from that of the cases reported previously, so the authors discucussed the possible mechanism of portal hypertension in this case.
