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Fibrin ring granulomas in hepatitis A
M Ruel1, H Sevestre, E Henry-Biabaud
1Médecine interne et gastro-entérologie, Hôpital de Senlis, Senlis, France.
Abstract:
Fibrin ring granuloma is characterized by a fibrinous ring surrounding a central fat vacuole. It has been found in the liver and bone marrow of patients with Q fever, and occasionally with visceral leishmaniasis, cytomegalovirus, Epstein-Barr virus, Staphylococcus epidermidis infections, Hodgkin's lymphoma, and hypersensitivity to allopurinol. We describe a case of serologically confirmed viral hepatitis A with this lesion in the liver biopsy. A false positive anti-hepatitis A virus IgM result has been excluded. This is, to our knowledge, the second reported case of type A hepatitis with hepatic fibrin ring granulomas. It confirms that hepatitis A should be included in the differential diagnosis of this lesion.
Insights
Fibrin ring granulomas, typically seen in infections and lymphomas, were observed in a patient with viral hepatitis A. This finding suggests hepatitis A should be considered in diagnosing hepatic fibrin ring granulomas.
Area of Science:
- Hepatology
- Pathology
- Infectious Diseases
Background:
- Fibrin ring granuloma is a distinctive histological finding characterized by a fibrinous ring and central fat vacuole.
- This lesion has been associated with various conditions including Q fever, visceral leishmaniasis, viral infections, lymphomas, and drug hypersensitivity.
Observation:
- A case of serologically confirmed viral hepatitis A is presented with the presence of hepatic fibrin ring granulomas in a liver biopsy.
- A false positive anti-hepatitis A virus IgM result was rigorously excluded.
Findings:
- This report details the second known case of viral hepatitis A associated with hepatic fibrin ring granulomas.
- The findings confirm a link between hepatitis A infection and the formation of fibrin ring granulomas in the liver.
Implications:
- Hepatitis A virus infection should be included in the differential diagnosis for patients presenting with hepatic fibrin ring granulomas.
- This association expands the etiological spectrum of fibrin ring granuloma, aiding in accurate diagnosis and patient management.