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Laparoscopic Anterior Right Hepatectomy: A Single-Center Experience
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Hepatic granulomas: a 17-year single tertiary centre experience.
Rui Gaspar1, Patricia Andrade1, Marco Silva1
1Gastroenterology Department, Centro Hospitalar São João, Faculty of Medicine of the University of Porto, Porto, Portugal.
Histopathology
|April 1, 2018
Summary
Hepatic granulomas, often found in liver biopsies, show a shift in causes over time. Initially linked to infections like tuberculosis, recent trends point towards autoimmune liver diseases as the primary etiology.
Area of Science:
- Hepatology
- Gastroenterology
- Pathology
Background:
- Hepatic granulomas are observed in approximately 5% of liver biopsies.
- Etiologies for hepatic granulomas are diverse and vary globally.
- Understanding the causes is crucial for appropriate patient management.
Purpose of the Study:
- To evaluate the clinical significance of hepatic granulomas.
- To identify the presenting features and underlying causes of hepatic granulomas.
- To analyze trends in granuloma etiology at a tertiary referral center.
Main Methods:
- Retrospective review of adult liver biopsy data from 1998 to 2014.
- Inclusion of clinical, laboratory, and histological findings.
- Exclusion of lipogranulomas and cases not managed at the institution.
Main Results:
- 297 cases of hepatic granulomas identified; tuberculosis (35.8%) and primary biliary cholangitis (15.0%) were most common.
- A significant shift in etiology observed: infectious diseases predominated (1998-2006), while autoimmune liver diseases became more prevalent (2006-2014).
- Idiopathic granulomas accounted for 12.5% of cases.
Conclusions:
- Hepatic granulomas stem from diverse infectious and non-infectious causes.
- An epidemiological shift from infectious to autoimmune etiologies is evident.
- Accurate diagnosis through work-up is essential for targeted therapies.
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