Polyarteritis Nodosa and Other Vasculitides
Laura Webb Lamps, MD
Key Facts
Etiology/Pathogenesis
Liver and gallbladder involved in > 40% of cases of polyarteritis nodosa (PAN)
Gallbladder involvement occasionally isolated rather than part of systemic process
Liver and gallbladder rarely involved in vasculitides other than PAN
Clinical Issues
Common presenting complaints include fever, abdominal pain
Laboratory findings usually reflect severe systemic inflammation
Microscopic Pathology
Hallmark lesion of PAN is fibrinoid necrosis involving medium-sized arteries
 This liver involved by polyarteritis nodosa features a medium-sized artery with fibrinoid necrosis, early fibrosis, and luminal narrowing. Note bile duct  . |
 Fibrinoid necrosis  is seen within the wall of a medium-sized artery in the liver. This lesion is the hallmark of polyarteritis nodosa. |
TERMINOLOGY
Abbreviations
Polyarteritis nodosa (PAN)
Definitions
Involvement of liver &/or gallbladder by vasculitis (inflammation of blood vessels)
ETIOLOGY/PATHOGENESIS
Liver
Liver involved in > 40% of cases of polyarteritis nodosa (PAN)
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