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. 2004 Feb;57(2):155-8.
doi: 10.1136/jcp.2003.11965.

Hepatic myospherulosis complicating portal vein embolisation

P C W Lui  1 , I S C Luk, C K L Lee, Y H Lui, C Y Leung, C H Choi
Affiliations

Hepatic myospherulosis complicating portal vein embolisation

P C W Lui et al. J Clin Pathol. 2004 Feb.

Abstract

Aims: Myospherulosis is a rare condition characterised by sac-like structures containing spheroid bodies in cysts or cystic spaces in the tissue. This condition has not previously been reported in the liver. The association with previous portal vein embolisation using a mixture of butyl 2-cyanoacrylate and ethiodised oil and the proposed mechanism of pathogenesis are discussed.

Methods: Samples from 8 patients treated by hepatectomy after portal vein embolisation using a mixture of butyl 2-cyanoacrylate and ethiodised oil were retrieved from the archives of the United Christian Hospital, Hong Kong. The histological specimens were reviewed. A panel of histochemical and immunohistochemical stains was used.

Results: All cases showed hepatic myospherulosis within the veins. The veins were denuded of endothelium, which was replaced by granulation tissue and fibrous tissue with a lymphoplasmacytic infiltrate. Foreign body-type giant cells (six cases) and eosinophilic infiltrates (seven cases) were noted in most cases. Both parent bodies and endobodies were stained red by Papanicolaou and Masson's trichrome and stained blue by solochrome cyanine. The endobodies showed immunoreactivity towards glycophorin A. They were negative for Alcian blue, periodic acid Schiff, Grocott, and Ziehl-Neelsen stains.

Conclusions: The endobodies of myospherulosis may be misdiagnosed as fungi or algae by the unwary. The clinical history, intravascular location, lack of staining with periodic acid Schiff and Grocott stains, and positive glycophorin A staining are generally sufficient for a confident diagnosis of myospherulosis.

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Figures

Figure 1
Figure 1
High magnification photomicrograph showing aggregates of altered red cells (endobodies) surrounded by a thin membrane (parent bodies) (original magnification, ×40; haematoxylin and eosin stain).
Figure 2
Figure 2
Photomicrograph showing a denuded vein with lymphocytic and eosinophilic infiltrates. Spheroid bodies are encysted within small spaces in the vascular lumen (haematoxylin and eosin stain).
Figure 3
Figure 3
Photomicrograph showing foreign body-type giant cells in the denuded vein (haematoxylin and eosin stain).
Figure 4
Figure 4
Photomicrograph showing positive immunoreactivity towards glycophorin A.
See this image and copyright information in PMC

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