Liver and intrahepatic bile ducts-nontumor
Hepatitis - noninfectious
Granulomatous hepatitis – noninfectious
Reviewers: Komal Arora, M.D. (see Reviewers page)
Revised: 30 April 2012, last major update April 2012
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● Granulomatous liver disease (infectious and non-infectious) in 4% of liver biopsies (Clin Liver Dis 2010;14:605)
● See also Granulomatous hepatitis - infectious
● Chronic granulomatous disease of childhood: necrotizing poorly formed granulomas with lipofuscin in histiocytes
● Crohn’s disease: see topic
● Drug/toxin induced hepatitis: see topic
● Foreign material: periportal talc or other material from intravenous drug abusers, periportal silicone in dialysis patients, amyloid
● Idiopathic: 10% of all granulomatous disease (infectious and non-infectious); numerous non-caseating granulomas, usually lobular; may precede sarcoidosis; a diagnosis of exclusion; good prognosis if remain in idiopathic group after workup; some patients may require corticosteroids (J Clin Pathol 2003;56:850)
● Lipogranulomas: usually centrilobular, contain lipid, variable steatosis in adjacent liver; may be a response to endogenous and dietary lipid; no additional evaluation required
● Malignancy: epithelioid granulomas occur in Hodgkin’s lymphoma and other malignancies, but do not imply metastatic spread
● Primary biliary cirrhosis: see topic
● Sarcoidosis: see topic
Multiple non-caseating granulomas and typical Langerhans giant cells
Fibrin-ring granuloma: fat vacuole surrounded by ring of fibrin deposition and epithelioid cells
Due to sulfa drugs
End of Liver and intrahepatic bile ducts-nontumor > Hepatitis - noninfectious > Granulomatous hepatitis – noninfectious
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