Studies on vascular lesions of the liver, gallbladder and pancreas in collagen diseases have rarely been documented.
The author systematically and histopathologically examined vascular lesions of the liver, gallbladder and pancreas in 62 autopsy cases of collagen diseases, including 25 of systemic lupus erythematosus (SLE), 13 of rheumatoid arthritis (RA), seven of polyarteritis (PN), six of progressive systemic sclerosis (PSS), four of dermatomyositis (DM), two each of allergic granulomatous angitis (AGA), and Wegener's granulomatosis (WG), and one each of mixed connective tissue disease (MCTD), Schönlein Henoch purpura (S-H P), and adjuvant disease (Adj).
The results were as follows :
1) Thirty-five out of 62 revealed panarteritis with fibrinoid degeneration (14 cases) or arterial scar lesions (21 cases).
2) The arterial lesions were predominantly distributed in the hepatic hilus, the gallbladder and the pancreatic head areas.
3) The lumina of the branches of the hepatic and splenic arteries in the SLE, RA, PN and PSS groups were much narrower than those of the main hepatic and splenic arteries in each group, except for the branch of the splenic artery in RA.
4) The incidence of luminal stenosis (over 40%) of branches of the hepatic and splenic arteries was higher in the groups with SLE, RA, PN and PSS than in the control group. More severe arterial luminal stenosis (over 75 %) was frequently found to be associated with arteritis.
5) The pathological findings of the liver consisted of necrosis of the hepatic cells, congestion, fatty metamorphosis of the hepatic cells, bile stasis, inflammatory cell infiltration and fibrosis in the periportal area.
6) A higher incidence of fatty metamorphosis of the hepatic cells was observed in the group receiving more than 2500mg of steroids (prednisolone) than in that administered less than 2500mg.
7) The pathological findings of the pancreas consisted of arteriolar hyalinosis, partial hyalinosis of the islets, focal parenchymal necrosis and fibrosis.
8) In one case of MRA, focal pancreatic necrosis was confirmed to have been caused by arteritis with mural occlusive thrombosis. In one case of AGA. mucosal erosion of the gallbladder was highly presumed histopathologically to have been caused by arteritis with severe luminal narrowing.
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