Chronic hepatitis C is a common associated with hepatic granulomas

• 作 者: Ned Snyder Juan G Martinez Shu
• 机 构: Department of Internal Medicine,Department of Pathology
• 出 处: 世界胃肠病学杂志
• 发表日期: 2004年期
• 关键词: Hepatitis C Liver Granulomas Liver biopsy
• 基金项目: the National Center for Research Resources, NIH, USPHS

AIM: To determine the most frequent etiologies of hepatic epithelioid granulomas, and whether there was an association with chronic hepatitis C virus (HCV). METHODS: Both a retrospective review of the pathol-ogy database of liver biopsies at our institution from 1996 through 2006 as well as data from a prospective study of hepatic fibrosis markers and liver biopsies from 2003 to 2006 were reviewed to identify cases of hepatic epithelioid granulomas. Appropriate charts, liver biopsy slides, and laboratory data were reviewed to determine all possible associations. The diagnosis of HCV was based on a positive HCV RNA. RESULTS: There were 4578 liver biopsies and 36 (0.79%) had at least one epithelioid granuloma. HCV was the most common association. Fourteen patients had HCV, and in nine, there were no concurrent condi-tions known to be associated with hepatic granulomas. Prior interferon therapy and crystalloid substances from illicit intravenous injections did not account for the finding. There were hepatic epithelioid granulomas in 3 of 241 patients (1.24%) with known chronic HCV enrolled in the prospective study of hepatic fibrosis markers. CONCLUSION: Although uncommon, hepatic granu-Iomas may be part of the histological spectrum of chronic HCV. When epithelioid granulomas are found on the liver biopsy of someone with HCV, other clini-cally appropriate studies should be done, but if nothing else is found, the clinician can be comfortable with an HCV association.