Journal article
Porto-sinusoidal vascular disorder (PSVD): Survey-based analysis of the usage and drawbacks of this newly proposed terminology
Human pathology, Vol.166, 105958
12/2025
DOI: 10.1016/j.humpath.2025.105958
PMID: 41135708
Abstract
The term "porto-sinusoidal vascular disorder" (PSVD) has been proposed for morphologic findings commonly seen in non-cirrhotic portal hypertension (PH) but can also be observed without clinically evident PH. To assess current practice patterns among U.S. liver pathologists, a 16-question survey was distributed along with two publications outlining the PSVD proposal. Nearly all respondents (n = 22, 95.75 %) were familiar with the PSVD terminology, but only 5 (21.75 %) used it as a final diagnosis, while 11 (47.75 %) had never used the term. In the presence of PH, 17 (74 %) preferred "obliterative portal venopathy", while only 1 (4.25 %) used PSVD. Notably, fewer than 5 % used PSVD in the context of nodular regenerative hyperplasia or incomplete septal fibrosis, although these have been proposed as part of the diagnostic criteria. A significant majority (n = 18, 78.25 %) disagreed with the proposed PSVD terminology, citing the following key concerns: labelling it as a disease entity is misleading (n = 20, 87 %), proposed diagnostic criteria are not supported by data (n = 15, 65.25 %), and labelling a process as PSVD does not seem accurate when only portal vein (n = 12, 52.25 %) or sinusoidal (n = 16, 69.5 %) changes are present. Over half (n = 13, 56.5 %) found it arbitrary to exclude certain vascular diseases from definition of PSVD (e.g., hepatic vein obstruction, sarcoidosis, schistosomiasis), given frequent histologic overlap across pre-hepatic, sinusoidal and post-hepatic etiologies of PH. In conclusion, "PSVD" terminology has not been adopted as a diagnostic term by most US liver pathologists who participated in this survey, emphasizing the need for a clearer, evidence-based terminology to describe these vascular changes.
Details
- Title: Subtitle
- Porto-sinusoidal vascular disorder (PSVD): Survey-based analysis of the usage and drawbacks of this newly proposed terminology
- Creators
- Nazire E Albayrak - University of California, San FranciscoDhanpat Jain - Yale UniversityMichael Torbenson - Mayo ClinicAndrew M Bellizzi - University of IowaDeyali Chatterjee - Vanderbilt University Medical CenterMaria Isabel Fiel - Icahn School of Medicine at Mount SinaiRyan M Gill - University of California, San FranciscoRaul S Gonzalez - Emory UniversityMaha Guindi - Cedars-Sinai Medical CenterJohn A Hart - University of ChicagoDavid E Kleiner - National Cancer InstituteGrace E Kim - University of California, San FranciscoBita V Naini - University of California, Los AngelesRish K Pai - Mount Sinai HospitalRostislav D Ranguelov - University of IowaNafis Shafizadeh - Woodland Hills Medical CenterHeather L Stevenson - The University of Texas Medical Branch at GalvestonHanlin Wang - University of California, Los AngelesStephen C Ward - Icahn School of Medicine at Mount SinaiKwun Wah Wen - University of California, San FranciscoSanjay Kakar - University of California, San Francisco
- Resource Type
- Journal article
- Publication Details
- Human pathology, Vol.166, 105958
- DOI
- 10.1016/j.humpath.2025.105958
- PMID
- 41135708
- NLM abbreviation
- Hum Pathol
- ISSN
- 0046-8177
- eISSN
- 1532-8392
- Publisher
- Elsevier
- Language
- English
- Electronic publication date
- 10/22/2025
- Date published
- 12/2025
- Academic Unit
- Pathology
- Record Identifier
- 9985019150502771
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