Liver and intrahepatic bile ducts - nontumor
Vascular disorders
Peliosis hepatis

Author: Komal Arora, M.D. (see Authors page)

Revised: 9 November 2017, last major update May 2012

Copyright: (c) 2002-2017,, Inc.

PubMed Search: Peliosis hepatis[TI] liver[TIAB] full text[sb]

Cite this page: Arora, K. Peliosis hepatis. website. Accessed December 13th, 2017.
Definition / general
  • Multiple blood filled cysts in liver or spleen
  • Associated with steroids (anabolic, contraceptive), danazol, azathioprine, Bartonella henselae infection in HIV+ patients
  • Also associated with liver or renal transplants, Castleman disease, nodular regenerative hyperplasia, leukemia / lymphoma, vinyl chloride exposure
  • Usually incidental finding at autopsy but may cause fatal intra-abdominal hemorrhage
  • May be due to hepatocellular necrosis, veno-occlusive disease
  • Erythromycin or doxycycline for Bartonella henselae infections
Gross description
  • Honeycombed liver with multiple round, red purple, blood filled spaces, 0.2 to 5 cm
Microscopic (histologic) description
  • Blood lakes surrounded by hepatic cords with variable endothelium
  • Spaces may be continuous
  • Sinusoidal dilation away from pools
  • May have herniation of hepatocytes into central veins; also fibrosis, organizing thrombus, hepatocellular necrosis
  • B. henselae patients have small blood vessel proliferation and spindle cells in liver and spleen
Positive stains
  • Warthin-Starry (Bartonella henselae infection / bacillary angiomatosis in HIV patients)
Differential diagnosis