PMC8721405_01
Imaging study. (a) Abdominal CT findings showing shrunken liver and gall bladder wall thickening with massive ascites. (b) Normal portal vein flow on Doppler ultrasonography (estimated velocity = 21.3 cm/s).
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Table 1). The CT scan showed a shrunken liver without splenomegaly and a moderate amount of ascites (Figure 1(a)), which were interpreted as liver cirrhosis following chronic hepatic GVHD by the radiologist and hepatologist rather than the expected VOD/SOS findings. In addition, the Doppler ultrasonography indicated well-preserved triphasic portal vein flow with a velocity of 21.3 cm/s (Figure 1(b)).
Post-hepatectomy histopathologic findings consistent with VOD/SOS and chronic hepatic GVHD. (a) Multifocal dilated sinusoids with hepatocyte atrophy (checked arrow) with extensive extravasation of red blood cells (solid arrow) showing hemorrhage (x100). (b) Cholestasis and bile duct dystrophy (arrow) without evidence of portal fibrosis (x400).
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We also observed some bile duct dystrophy and cholestasis which was considered findings of hepatic GVHD (Figure 2).