Peliosis hepatis (peliosis = "extravasation of blood") is believed to occur when there is obstruction at the junction between the sinusoids and central veins of the liver, resulting in blood accumulation and sinusoidal distention.
Pathologic features:
(1) There may be intra-abdominal hemorrhage or hemorrhage beneath the hepatic capsule if cystic lesions have ruptured.
(2) Multiple reddish-purple-bluish lesions may be grossly visible in the liver as well as spleen, lymph nodes or other organs. The lesions may range from microscopic lesions to cystic areas several centimeters in diameter.
(3) The lesions consist of blood-filled cystic cavities (lacunae) with rupture of reticulin fibers.
(4) The lesions may be classified as parenchymal (if hepatocyte necrosis present) or phlebectacic (if there is degeneration of reticulin fibers).
(5) The spaces may or may not have an endothelial lining.
Lesions may show or be associated with:
(1) thrombosis
(2) dystrophic calcifications
(3) hemorrhage
(4) cholestasis
Differential diagnosis:
(1) hemangioma
(2) vascular malformation
(3) angiosarcoma
(4) vascular congestion
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