Liver and intrahepatic bile ducts - nontumor
Hepatitis - noninfectious
Granulomatous hepatitis - noninfectious

Author: Anthony W.H. Chan, FRCPA (see Authors page)

Revised: 31 October 2017, last major update May 2015

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Granulomatous hepatitis[TI] liver full text[sb]

Cite this page: Chan, A.W.H. Granulomatous hepatitis - noninfectious. PathologyOutlines.com website. http://pathologyoutlines.com/topic/livergrannoninfect.html. Accessed December 14th, 2017.
Definition / general
Etiology
Case reports
Microscopic (histologic) description
  • Morphology (epithelioid, suppurative, fibrin ring or lipogranuloma) may suggest underlying etiology
  • Epithelioid granuloma: infectious and noninfectious (e.g. primary biliary cirrhosis, drug induced liver injury, foreign body reaction, sarcoidosis, Crohn's disease, chronic granulomatous disease, lymphoma)
  • Caseating epithelioid granuloma: typically associated with infections, most notably tuberculosis
  • Suppurative granuloma (granulomatous inflammation with stellate abscess formation or suppurative inflammation): bartonellosis, yersinosis, tularemia, listerosis, melioidosis, actinomycosis and fungal infection (see granulomatous hepatitis - infectious)
  • Fibrin ring granuloma (also known as doughnut granuloma; central fat globule surrounded by a circumferential rim of fibrin and histiocytes): originally pathognomonic for Q fever (Coxiella burnetii); now considered as nonspecific and could be associated with mycobacterial infection, staphylococcal bacteremia, leishmaniasis, toxoplasmosis, cytomegalovirus, Epstein-Barr virus, acute hepatitis A, systemic lupus erythematosus, allopurinol toxicity and lymphoma
  • Lipogranuloma (central fat globule surrounded by histiocytes without fibrin ring): alcoholic and nonalcoholic fatty liver disease, mineral oil
Microscopic (histologic) images

Images hosted on other servers:
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Multiple noncaseating granulomas

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Fibrin ring granuloma

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Due to sulfa drugs



Images contributed by Anthony W.H. Chan, FRCPA:
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Fibrin ring granuloma

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Classical Hodgkin lymphoma

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Trifluoperazine induced liver injury

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Primary biliary cirrhosis


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In sarcoidosis

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Lipogranuloma in nonalcoholic fatty liver disease