Epitheloid granuloma formation in type C chronic hepatitis: report of two cases

Two cases of type C chronic hepatitis with the presence of epitheloid granulomas were reported. Case 1 was a 44-year-old man who presented with a moderate increase in serum ALT and positive anti-HCV. Histological examination of percutaneous liver biopsy specimens showed dense portal inflammation with piecemeal necrosis. Lobular inflammation was present mederately and a large well-organized epitheloid granuloma was found within a liver lobule. Case 2 was a 55-year-old woman, who was presented because of a slight increase in serum ALT and positive anti-HCV. Histologically, liver biopsy specimens showed lymphoid aggregates in the portal area and slight piecemeal necrosis. Moderate steatosis were noted and an epitheloid granuloma was present in the hepatic lobule. Acid-fast stains were negative for both cases and serum ACE and lysozyme were within normal range. These granulomas were composed of epitheloid cells surrounded by lymphocytes. They were not present within the portal tracts, but were found in the hepatic lobule. The incidence of the appearance of epitheloid granuloma in liver biopsy specimens of type C chronic hepatitis was 2 out of 273 cases (0.73%). The role of HCV infection in the genesis of epitheloid granulomatosis is of much interest and should be investigated.