PMC6136408_01
Case 1: color Doppler sonographic evaluation. Complete inversion of the portal venous flow.
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The post-transplantation period was complicated by a severe VOD, with a complete inversion of the portal flow and an important ascite (Figure 1).
Case 1: center lobular hemorrhagic confluent liver cells necrosis around a central vein showing few inflammatory infiltrates within lumen, suggesting diagnosis of venoocclusive disease (H&E, 100x).
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Another histological feature was ductopenia (absence of interlobular bile ducts in portal tracts) suggestive of liver GVHD (Figure 2).
Case 1: liver with normal architecture; inflammatory infiltrate is completely absent. Diffuse swelling of liver cells cytoplasm suggesting toxic-related damage (H&E, 40x).
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The child underwent another liver biopsy that showed a histological feature suggestive of drug-induced liver injury (DILI) (Figure 3).
PMC6136408_02
Case 2: widespread structural anomalies of the portal venous vessels with dilated lumen, sometimes herniated in the perivascular parenchyma (CD34 immunoreaction, 40x).
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Widespread structural anomalies of the portal venous vessels appear numerically increased, with dilated lumen, sometimes herniated in the perivascular parenchyma (Figure 4).