Perivenular fibrosis

Central venules only contain a small amount of collagen, with the result that in this form of fibrosis, perivenous sinusoids are always involved as well. A typical example is perivenular fibrosis in chronic alcohol abuse, (s. fig. 21.16) Centrolobular fibrosis may also be detectable in healed viral hepatitis or following slight liver damage (e.g. Meulengracht s disease). Central hyaline sclerosis, which is due to chronic alcohol abuse with intermittently recurring alcohol hepatitis, is known to be a particularly severe form of fibrosis, (s. p. 526)... 

A 28-year-old man presented with jaundice after taking six tablets of skullcap (together with zinc and pau d arco) daily for the previous 6 months to help his multiple sclerosis. His liver enzjmes were raised and hepatitis A, B, and C serologies were negative. He developed progressive liver failure and received a transplant but died shortly after. His explanted hver showed fibrous stenosis and obliteration of most of the terminal venules with extensive perivenular fibrosis, indicative of veno-occlusive disease. 

Fig. 21.16 Perivenular and perisinusoidal fine-meshed fibrosis and discreet cellular inflammatory reaction as a result of chronic alcohol abuse (CV = central vein) (Ladewig)...

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