Sinusoidal Obstruction Syndrome (SOS) in Multiple Myeloma with Renal Failure

Figure 2

Schematic representation of the hepatic lobule and acinus. The acinus is the physiological unit of the liver and is divided into three zones, according to distance from the afferent arterial supply. Sinusoids are distensible vascular channels bounded circumferentially by hepatocytes and lined with SEC. As blood flows through the sinusoids, plasma is filtered through pores in the endothelium into the space between endothelium and hepatocytes (the “space of Disse”) as lymph. In SOS, obstruction to the sinusoids develops in zone 3. This leads to pathological increased pressure in the sinusoids and an increase in the rate of lymph production, which accumulates in the abdominal cavity as ascites.