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Hepatic granulomas in Turkey: a 6-year clinicopathological study of 35 cases
Memduh Sahin1, Güldal Yılmaz, Mehmet Arhan
1Department of Gastroenterology, Gazi University Faculty of Medicine, Ankara, Turkey. memduhsahin@gazi.edu.tr.
Background/Aims:
Granulomas are focal aggregates of modified macrophages that are surrounded by a rim of lymphocytes and fibroblasts. The present study aimed to evaluate the prevalence and etiology of hepatic granulomas (HGs) in the Department of Gastroenterology with a wider population.
Materials And Methods:
We performed a retrospective study on 2662 liver biopsy specimens analyzed between 2005 and 2011 at Gazi University Department of Gastroenterology to determine the presence of HGs.
Results:
There were 16 cases with primary biliary cirrhosis, of whom 14 without any other causative etiology. There were 6 cases of sarcoidosis, 2 cases of Fasciola hepatica infection, 2 cases of hepatitis C, and 2 cases of hepatitis B. One case had both tuberculosis and rheumatoid arthritis and one case had both tuberculosis and brucellosis. There was also one case each of leishmaniasis and Hodgkin's lymphoma. The diagnosis of autoimmune hepatitis was found in two cases. One case had immune cholangiopathy.
Conclusion:
The leading causative etiology of HGs was primary biliary cirrhosis, followed by sarcoidosis. As a study performed in a center that accepts patient profiles throughout Turkey, tuberculosis took a minor part in HG etiology. A drug-affected or toxic case of HG was not observed.
Insights
This study found primary biliary cirrhosis and sarcoidosis to be the most common causes of hepatic granulomas (HGs). Tuberculosis was a less frequent cause in this Turkish population, with no drug-induced cases identified.
Area of Science:
- Hepatology
- Pathology
- Immunology
Background:
- Hepatic granulomas (HGs) are inflammatory responses in the liver.
- Understanding HG etiology is crucial for diagnosis and management.
Purpose of the Study:
- To determine the prevalence and etiological factors of hepatic granulomas.
- To analyze a large cohort of liver biopsy specimens.
Main Methods:
- Retrospective analysis of 2662 liver biopsy specimens.
- Specimens analyzed between 2005 and 2011.
- Identification of hepatic granulomas and their associated causes.
Main Results:
- Primary biliary cirrhosis was the leading cause (16 cases).
- Sarcoidosis was the second most common etiology (6 cases).
- Infectious causes like Fasciola hepatica, hepatitis B, and hepatitis C were identified, along with tuberculosis and autoimmune conditions.
Conclusions:
- Primary biliary cirrhosis and sarcoidosis are the primary drivers of hepatic granulomas in this cohort.
- Tuberculosis contributed minimally to HG etiology in this Turkish center.
- No drug-induced or toxic causes of hepatic granulomas were observed.
