Fig. 2: Abnormal portal/periportal vessel is a poor histologic predictor for idiopathic noncirrhotic portal hypertension (INCPH), despite being well described as characteristic features.

a Liver biopsy from a patient with abnormal liver function tests and no history of PH showing multiple herniated venous structures. A few thin-walled vessels are present (to the upper right of the portal tract), creating a sieve-like appearance. b Liver biopsy from another non-INCPH patient showing paraportal shunt formation. c A portal tract with a herniated venous structure without any intervening connective tissue separating the herniated vein wall from the lobule. We note that the portal tracts containing herniated venous structures in non-INCPH biopsies tend to have no or minimal portal fibrosis and rarely exhibit rounded contours.