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Transient abdominal granulomas in children.
J L Fleckenstein1, J C Argyle, J M Cohen
1Department of Radiology, University of Texas Southwestern Medical Center, Dallas 75235-9085.
The Pediatric Infectious Disease Journal
|April 1, 1989
Summary
Space-occupying liver lesions in febrile children can be transient, sterile granulomas, not just tumors or infections. This finding expands the differential diagnosis for hepatic nodules in pediatric fever of unknown origin.
Area of Science:
- Pediatric Radiology
- Hepatology
- Pathology
Background:
- Space-occupying liver lesions in febrile patients are typically attributed to tumors or infections.
- Other causes are rarely considered in the differential diagnosis.
Observation:
- Five pediatric patients (20 months to 12 years) presented with fever of unknown origin.
- Imaging revealed hepatic nodules initially suspected to be neoplastic or infectious.
Findings:
- Histological examination showed transient, sterile granulomas with stellate architecture.
- Imaging findings, including peripheral low density on CT and hyperintense halos on MRI, mimicked neoplastic disease but were associated with granulomas.
- No definitive cause for the granulomas was identified.
Implications:
- Transient, idiopathic granulomas should be included in the differential diagnosis of liver lesions in febrile children.
- This broadens the diagnostic considerations beyond common etiologies like tumors and infections.
- Accurate diagnosis can prevent unnecessary invasive procedures or treatments.