A Case Showing Peculiar Reddish Markings Followed by Kalk's Patchy Markings on Liver Surface

Kubota, Masahiro; Shimada, Yoshihiro; Itoshima, Tatsuya; Ohta, Wataru; Inoue, Takemichi; Fukuhara, Junichi; Ukida, Minoru; Kita, Toru; Hirohata, Mamoru; Yamada, Gotaro

doi:10.2957/kanzo.15.94

Cited by 3 publications

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Reddish markings obtained via punch biopsy were classified as star‐like ( n = 8), net‐like ( n = 10) or hemorrhagic fleck‐like ( n = 12) according to the macroscopic form 2–5,17 . Histopathological examination of the 30 lesions obtained by punch biopsy demonstrated that the reddish markings on the liver surface did not correspond with piecemeal necrosis, but with hepatic parenchymal destruction subjacent to the liver capsule.…”

Section: Resultsmentioning

confidence: 99%

“…He guessed that the cause of the clear bright color of the markings might be the mixture of blood from portal and arterial supplies flowing in sinusoids that remained in lesions of necrosis. Because of this histological examination, reddish markings have been established as an index of activity for chronic hepatitis 2–5 . However, by no means do all cases of chronic active hepatitis display reddish markings.…”

Section: Discussionmentioning

confidence: 99%

“…Since then, numerous papers have investigated the clinical significance of reddish markings in Japan. Although these reddish markings have frequently been described as important laparoscopic findings indicating active hepatitis and the development of chronic hepatitis, 2–5 other papers have indicated that these markings do not necessarily denote active hepatitis 6,7 . The clinical relevance of these markings is therefore unclear.…”

Section: Introductionmentioning

confidence: 98%

“…Shimada et al . described ‘periportal reddish markings’ for the first time in Japan, and reported the clinical significance of this finding 2,3 . Since then, numerous papers have investigated the clinical significance of reddish markings in Japan.…”

Section: Introductionmentioning

confidence: 99%

“…The clinical relevance of these markings is therefore unclear. In addition, confusion exists between papers stating that periportal reddish markings recognized under laparoscopy mean active hepatitis and others stating that piecemeal necrosis recognized histologically in the periportal area means active hepatitis 2–5,8 . Given the above confusion, reddish markings observed under laparoscopy have been mistakenly considered to correspond with the lesions of piecemeal necrosis observed on histology.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Formation and clinical significance of reddish markings on the liver surface: Activity of chronic liver disease

Shibayama¹,

Ohtake²,

Hishima

2003

Digestive Endoscopy

View full text Add to dashboard Cite

Background: The aim of this study was to clarify the clinical significance of reddish markings appearing on the surface of the liver. Methods: Subjects were patients with Hepatitis B virus‐related (n = 232) or Hepatitis C‐related (n = 246) chronic liver disease. Reddish lesions were obtained from this population using punch biopsy (n = 30) or wedge biopsy (n = 4), then studied histopathologically. In addition, the incidence and macroscopic forms of reddish markings in each laparoscopic stage for the 478 subjects were examined to determine when reddish markings appeared. Results: Reddish markings on the liver surface appeared only after the appearance of hepatic parenchymal destruction subjacent to the liver capsule, rather than with the appearance of piecemeal necrosis in the portal area. Moreover, following expansion of necrotic hepatic parenchyma subjacent to the liver capsule and distortion of hepatic lobular architecture in this lesion, net‐like or hemorrhagic fleck‐like reddish markings appeared. Therefore, this was recognized as changes at the liver capsule, such as capillary proliferation and dilatation, and blood flow changes in both the capsule and hepatic parenchymal lesions subjacent to the liver capsule. With regards to timing, reddish markings were most frequently observed in the transition to liver cirrhosis. After the appearance of reddish markings on the liver surface, chronic hepatitis rapidly progressed to liver cirrhosis. Conclusion: Reddish markings correspond to hepatic parenchymal destruction subjacent to the liver capsule, and not to piecemeal necrosis. Reddish markings appear in the transition to liver cirrhosis and might offer a useful marker of the progression to liver cirrhosis.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Formation and clinical significance of reddish markings on the liver surface: Activity of chronic liver disease

Shibayama¹,

Ohtake²,

Hishima

2003

Digestive Endoscopy

View full text Add to dashboard Cite

show abstract

Peritoneoscopy of the liver stained by intravenous injection of indocyanine green—experimental and clinical studies

et al. 1983

View full text Add to dashboard Cite

Liver surface patterns were observed by peritoneoscopy after intravenous injection of indocyanine green (ICG). The normal rat liver was diffusely stained dark greenish-brown 5 minutes after the injection of ICG 25 mg/kg body weight into the tail vein. Green spots persisted longer in the centrolobular area, clearly revealing lobular markings. This regional difference in hepatocyte staining suggested differing abilities of hepatocytes to take up or excrete ICG. This dyeing technique was applied to liver disease patients. The liver was diffusely stained light greenish-brown 5 minutes after the injection of ICG 5 mg/kg body weight. In patients, especially those with obscure lobular markings before ICG injection, lobules were clearly demarcated by reddish terminal portal veins against a green background. This simplified detection of lobular distortions. Prenodular patches (Kalk's Bunteflecke) on the liver surface were stained green more intensely than surrounding areas, which supports the hypothesis that patches are composed of active hepatocytes.

show abstract

Peritoneoscopic study on rat liver cell necrosis induced by carbon tetrachloride and allyl formate

et al. 1982

View full text Add to dashboard Cite

The surface changes of acute centrolobular and perilobular necrosis were studied in rat liver using peritoneoscopy. Centrolobular necrosis as induced by carbon tetrachloride and perilobular necrosis by allyl formate. Vessels observed on the control rat liver surface were identified as terminal hepatic veins by irrigation of the hepatic vein with a barium solution. Polygonal whitish markings were observed on the liver surface 48 hours after carbon tetrachloride administration. Terminal hepatic veins were regularly distributed throughout the central portions of the whitish areas. Reddish spots about 0.1 mm in diameter were scattered about the terminal hepatic veins. The reddish spots and whitish areas corresponded to the histological findings of central liver cell necrosis and infiltration by Kupffer and white blood cells. Six hours after allyl formate administration, round reddish spots about 0.3 mm in diameter were regularly distributed on the liver surface among the terminal hepatic veins. These spots corresponded to the histological findings of liver cell necrosis around the portal area. In summary, acute centrolobular and perilobular liver cell necrosis were newly observed as reddish spots by peritoneoscopy.

show abstract

A Case Showing Peculiar Reddish Markings Followed by Kalk's Patchy Markings on Liver Surface

Cited by 3 publications

References 0 publications

Formation and clinical significance of reddish markings on the liver surface: Activity of chronic liver disease

Formation and clinical significance of reddish markings on the liver surface: Activity of chronic liver disease

Peritoneoscopy of the liver stained by intravenous injection of indocyanine green—experimental and clinical studies

Peritoneoscopic study on rat liver cell necrosis induced by carbon tetrachloride and allyl formate

Contact Info

Product

Resources

About