Peliosis hepatis anabolic steroids

Peliosis is a rare lesion of unknown incidence and cause, characterized by the presence of blood-filled cysts. It has been most often reported to affect the liver ( peliosis hepatis ), sometimes in association with the use of anabolic steroids, but it has also been localized elsewhere in the mononuclear phagocytic system, such as the spleen, bone marrow, and lymph nodes, and occasionally at other sites. Pulmonary peliosis has been reported in a 29-year-old man who was abusing testosterone [ 102 A ]. This appears to be only the third published case involving the lungs, and it is highly unusual in that no other organ system was affected.

Laws and Penalties:  Concerns over growing illegal AAS abuse by teenagers, and many of the just discussed long-term effects, led Congress in 1991 to place the whole AAS class of drugs into Schedule III of the Controlled Substances Act (CSA).  Under this legislation, AAS are defined as any drug or hormonal substance, chemically and pharmacologically related to T (other than estrogens, progestins, and corticosteroids) that promotes muscle growth.  The possession or sale of AAS without a valid prescription is illegal.  Since 1991, simple possession of illegally obtained AAS carry a maximum penalty of one year in prison and a minimum $1,000 fine if this is an individual’s first drug offense.  The maximum penalty for trafficking (selling or possessing enough to be suspected of selling) is five years in prison and a fine of $250,000 if this is the individual’s first felony drug offense.  If this is the second felony drug offense, the maximum period of imprisonment and the maximum fine both double.  While the above listed penalties are for federal offenses, individual states have also implemented fines and penalties for illegal use of AAS.  State executive offices have also recognized the seriousness of AAS abuse and other drugs of abuse in schools. For example, the State of Virginia enacted a law that will allow student drug testing as a legitimate school drug prevention program (48, 49).

Two morphologic patterns of hepatic peliosis were described by Yanoff and Rawson. [7] In the phlebectatic type, the blood-filled spaces are lined with endothelium and are associated with aneurysmal dilatation of the central vein; in the parenchymal type, the spaces have no endothelial lining and they usually are associated with haemorrhagic parenchymal necrosis. Some consider both patterns to be one process, initiated by focal necrosis of liver parenchyma, observed in parenchymal type, progressing into formation of fibrous wall and endothelial lining around haemorrhage of phlebectatic type. Fibrosis , cirrhosis , regenerative nodules, and tumours may also be seen.

Sarcoidosis is a disease of unknown etiology in which noncaseating granulomas form in tissues and organs of the body and have a predilection for the lymphatic system. The spleen is involved in 24-59% of patients with sarcoid but usually is asymptomatic. Those with marked involvement can develop abdominal symptoms. Severe cases can lead to hypersplenism and spontaneous rupture of uncertain etiology. [ 7 ] Most commonly, the spleen is diffusely affected, and the findings can mimic those of lymphoma. Splenomegaly is apparent in approximately one third of patients and frequently shows associated lymphadenopathy. Discrete hypoattenuating nodules are present on CT scans in approximately 15% of patients; these result from aggregated granulomas.

Peliosis hepatis anabolic steroids

peliosis hepatis anabolic steroids

Sarcoidosis is a disease of unknown etiology in which noncaseating granulomas form in tissues and organs of the body and have a predilection for the lymphatic system. The spleen is involved in 24-59% of patients with sarcoid but usually is asymptomatic. Those with marked involvement can develop abdominal symptoms. Severe cases can lead to hypersplenism and spontaneous rupture of uncertain etiology. [ 7 ] Most commonly, the spleen is diffusely affected, and the findings can mimic those of lymphoma. Splenomegaly is apparent in approximately one third of patients and frequently shows associated lymphadenopathy. Discrete hypoattenuating nodules are present on CT scans in approximately 15% of patients; these result from aggregated granulomas.

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