More on hepatic granulomas

Abstract

We have read the case report of Nihon-Yanagi et al. The patient they described developed hepatic granuloma two times and the granulomatous lesion was surrounding metal staples/clips suggesting that the granuloma was due to surgical staples/clips.Hepatic granulomas (HGs) are reported in around 5 % of patient who undergo a liver biopsy and caused by several diseases including sarcoidosis, tuberculosis, hydatid cyst, brucellosis, typhoid fever, chronic hepatitis B and C and primary biliary cirrhosis (PBC). Chronic hepatitis B and C infections are the most common and serious causes of liver damage in patient with renal failure. Their prevalence is a higher than people without renal failure. We have previously reported that the prevalences of HGs in patients with chronic hepatitis B and C are 1.5 and 1.3 % respectively. The described patient was on hemodialysis for 12 years. The other causes of HG seem excluded; however hepatitis B and C infections and PBC should have been tested and excluded before ascribing the HGs to surgical staples/clipping material.

Sarcoidosis with hepatic involvement: a case report

“…Otoimmun hastalıklar (Sarkoidoz, Primer bilier siroz, Wegener granülomatozisi, Crohn hastalığı); başta tüberküloz olmak üzere pek çok bakteriyel; sitomegalovirüs, Ebstein bar ve hepatit A,B,C gibi viral; histoplazmozis, kriptokokkozis gibi fungal; toksoplazmozis ve şistozomiazis gibi paraziter enfeksiyon etkenleri; malignite (özellikle Hodgkin lenfoma), ilaçlar ve idiopatik nedenler bunlardan bazılarıdır. [11,12] Tanı verilirken histopatolojik özellikler yanı sıra, hastaların diğer klinik ve laboratuar bilgileri önemlidir. Yapılan karaciğer biopsisi ile sarkoidoz tanısı kesinleştirilen olgunun takip ve tedavisi devam etmektedir.…”

Sarcoidosis with Hepatic Involvement: A Case Report

“…These include autoimmune diseases (sarcoidosis, primary biliary cirrhosis, Wegener's granulomatosis, Crohn's disease), bacterial infections (mainly tuberculosis); viral infections (cytomegalovirus, Epstein-Barr virus infections, hepatitis A,B,C infections) fungal infections (histoplasmosis, cryptococcosis), parasitoses (toxoplasmosis, schistosomiasis), malignancies (especially Hodgkin's lymphoma), medications, and idiopathic causes of disease. [11,12] When establishing a diagnosis, other clinical and laboratory findings of the patients in addition to histopathological characteristics are also important. The follow-up and treatment of this patient with a final diagnosis of sarcoidosis still continues.…”