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Necrotizing granulomatous hepatitis differential diagnosis

V I Vasilyev, S G Palshina, B D Chaltsev, S G Radenska-Lopovok, T N Safonova
The authors have described the world's first case of necrotizing sarcoid granulomatosis (NSG) in a 22-year-old woman with the clinical presentations of acute abdomen, which are associated with abdominal lymph nodal infiltration and necrosis, obvious constitutional disturbances (fever, nocturnal sweats, and significant weight loss), high inflammatory activity (anemia, leukocytosis, high erythrocyte sedimentation rates and C-reactive protein levels), the gradual appearance of splenic and hepatic necrotic foci, and infiltration into the lung and lacrimal glands with the development of unilateral uveitis...
2017: Terapevticheskiĭ Arkhiv
Nam Kyung Lee, Suk Kim, Dong Uk Kim, Hyung Ii Seo, Hyun Sung Kim, Hong Jae Jo, Tae Un Kim
Potentially, diffusion-weighted magnetic resonance imaging (DWI) can assess the functional information on concerning the status of tissue cellularity, because increased cellularity is associated with impeded diffusion. DWI in the hepatobiliary and pancreatic regions has demonstrated the usefulness to detect malignant lesions and differentiate them from benign lesions. However, it has been shown more recently that there is some overlap in ADC values for benign and malignant neoplasms. Moreover, some non-neoplastic lesions in the hepatobiliary and pancreatic regions exhibit restricted diffusion on DWI, because of pus, inflammation, or high cellularity...
March 2015: Abdominal Imaging
Taio Naniwa, Tomoyo Maeda, Shigeki Shimizu, Rei Ito
The patient presented here is a 59-year-old Japanese man with active chronic hepatitis B with precore and core promoter mutated virus, presenting with high fever, bloody sputum, and multiple lung nodules with excavation. Surgical biopsy of the lung nodule showed necrotizing vasculitis affecting pulmonary arteries without granulomatous changes. The pulmonary manifestations of this patient resembled Wegener granulomatosis. However, the pathologic findings showing nongranulomatous necrotizing vasculitis involving the small pulmonary arteries, presence of circulating immune complex, absence of antineutrophil cytoplasmic antibodies, and excellent response to the combination therapy of corticosteroid and an anti-hepatitis B virus agent, entecavir, led us to the diagnosis of hepatitis B virus-related polyarteritis nodosa (PAN)...
July 2010: Chest
Ziya Cetinkaya, Ercan Kocakoc, Serdar Coskun, Ibrahim Hanefi Ozercan
OBJECTIVES: To present a case of primary hepatic actinomycosis. CLINICAL PRESENTATION: A-40-year-old man was admitted to the general surgery clinic with a 1-month history of abdominal pain and weight loss. Liver transaminase, bilirubin levels and white blood cell counts were increased. Abdominal ultrasound and CT revealed cystic lesions with necrotic debris involving the posterior segment of the right lobe of the liver and the medial segment of the left lobe. INTERVENTION: The patient underwent surgery under general anesthesia...
2010: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
Olatunde B Akanbi, Angele Breithaupt, Ulf Polster, Thomas Alter, Anette Quandt, Andreas Bracke, Jens P Teifke
The occurrence of listeriosis in 12 caged canaries is described where 50% of the birds, including the female and all of the offspring, died within 2 weeks without clinical signs. At necropsy, multifocal necrotizing and partly granulomatous hepatitis, splenitis, myocarditis, interstitial nephritis, and exudative pericarditis with intra-lesional Listeria monocytogenes were the predominant findings as shown by histopathology and immunohistochemistry. Microbiology, serology and polymerase chain reaction revealed L...
June 2008: Avian Pathology: Journal of the W.V.P.A
Agatha I Kondi-Pafiti, Dimitra S Grapsa, Evi D Kairi-Vasilatou, Dionysios K Voros, Vasilios E Smyrniotis
AIM: The aim of the study is to further investigate the clinicopathological features of solitary necrotic nodules. MATERIAL AND METHODS: Twenty-three archived cases of solitary necrotic nodule of the liver, which were preoperatively misdiagnosed as liver metastases were studied. The pathological findings were correlated with the clinical data of the patients. RESULTS: The nodules were solitary in 20 cases and multiple (2) in three cases, and measured from 0...
2006: International Journal of Gastrointestinal Cancer
Antonela C Zanchi, Alan R Gingold, Neil D Theise, Albert D Min
No abstract text is available yet for this article.
October 2007: Digestive Diseases and Sciences
Hugo Bonatti, Julio Mendez, Ivan Guerrero, Murli Krishna, Jaime Ananda-Michel, Joseph Yao, Jeffery L Steers, Walter Hellinger, Rolland C Dickson, Salvador Alvarez
Bartonella henselae has not only been identified as the causative agent of cat scratch disease, but it is also associated with other significant infectious syndromes in the immunocompromised population. We describe two cases of B. henselae associated diseases in liver transplant recipients who both had contact with cats. The first recipient developed localized skin manifestation of bacillary angiomatosis in association with granulomatous hepatitis. He tested positive for Immunoglobulin G (IgG) antibodies against B...
August 2006: Transplant International: Official Journal of the European Society for Organ Transplantation
H J Stemmler, M Hoelzl, N Moosmann, C Becker, A Lennertz, G Babaryka
Atypical presentation of Churg-Strauss syndrome includes lymph-node and parenchymatous organ involvement which mimics the clinical presentation of lymphoproliferative disorders.A 54-year old man with a history of a low-grade follicular lymphoma presented with rapidly growing abdominal lymph-nodes and hepatic, renal and pulmonary infiltrations. CT guided biopsies to verify either lymphoma or infections showed eosinophilic, necrotizing, granulomatous vasculitis leading to the diagnosis of atypical Churg-Strauss syndrome...
May 2006: Der Internist
P Rey, C Bredin, C Carrere, N Froment, D Casassus-Builhe
INTRODUCTION: Toxocariasis is a common helminth infection that causes visceral larva migrans in humans. It has a wide and varied clinical spectrum. CASE: A 60-year-old woman consulted after 6 months of recurrent biliary pain with fever. Laboratory tests showed moderate disturbance of liver enzymes and hypereosinophilia (10 400/mm3). Imaging studies revealed a pseudotumor in hepatic segment IV, hyperechoic in abdominal ultrasound and low density in computed tomography...
December 17, 2005: La Presse Médicale
P Laochumroonvorapong, D P DiCostanzo, H Wu, K Srinivasan, M Abusamieh, H Levy
A 33-year-old Hispanic woman with newly diagnosed human immunodeficiency virus (HIV) infection, a CD4 T-lymphocyte count of 2, viral load of 730,000 copies/mL, candidal esophagitis, seizure disorder, a history of bacterial pneumonia, and recent weight loss was admitted with tonic clonic seizure. On admission, her vital signs were: pulse of 88, respiration rate of 18, temperature of 37.7 degrees C, and blood pressure of 126/76. Her only medication was phenytoin. On examination, the patient was found to have multiple umbilicated papules on her face, as well as painful, erythematous, large, punched-out ulcers on the nose, face, trunk, and extremities of 3 months' duration (Fig...
August 2001: International Journal of Dermatology
M Iwata, M Sasaki, K Harada, S Kaneko, K Kobayashi, K Adachi, M Sasaki, Y Nakanuma
Autoimmune hepatitis is a chronic liver disease characterized by immune-mediated, progressive hepatocellular damage, although the target autoantigen remains speculative. Intrahepatic biliary lesions are not a feature of this disease. We describe herein a female patient, 57 years, with autoimmune hepatitis who developed hepatic regenerative mass after acute exacerbation of hepatitis. This hepatic regenerative mass was clinically diagnosed as hepatocellular carcinoma and was surgically resected after transcatheter arterial embolization therapy...
2001: Pathology, Research and Practice
C Halimi, N Bringard, N Boyer, V Vilgrain, Y Panis, C Degott, J P Brouland, M Boudiaf, P Valleur, E Henry-Biabaud, D Valla
We report two new cases of hepatic brucelloma in addition to the 22 previously reported cases in the literature. Our analysis of these cases reveals certain characteristics. Hepatic brucelloma is a rare localization that follows previously undetected acute brucellosis. Brucelloma is a result of caseification of a granulomatous reaction induced by persistent Brucella in macrophages. Clinical manifestations can mimic malignant liver tumors or pyogenic, amebic liver abscess. Diagnosis is based on the association of characteristic imaging features (central calcification and peripheral necrotic areas), positive serology and hepatic granulomas...
April 1999: Gastroentérologie Clinique et Biologique
J Ludwig, F Colina, J J Poterucha
Granulomas in liver biopsy specimens from adult patients with chronic ductopenic cholestatic liver disease are a characteristic feature of primary biliary cirrhosis. However, we found a similar combination of abnormalities in 7 out of 100 native livers (7%) from patients who had orthotopic liver transplantation for primary sclerosing cholangitis. In a control group of native livers from 100 patients with primary biliary cirrhosis, the prevalence of granulomas was exactly the same, 7%. In the primary sclerosing cholangitis group, 13 addition livers showed a granulomatous epithelioid cell response, with or without foreign body type giant cells, to extravasated bile...
December 1995: Liver
J C Pons, H Teyssau, M Bureau, R Ruiz, J Surzur, J P Tessier
A case of isolated necrotizing, granulomatous hepatitis of Brucella origin is discussed, together with 6 similar cases reported in the published literature. The clinical picture is dominated by the history of the patient (occupation, geographical location), fever, right hypochondrial pain, and altered general condition. Radiological examination shows characteristic calcifications. Diagnosis is confirmed by serology, Brucella suis usually being involved. Pathological appearances are typical : large foci of hepatic necrosis surrounded by marked inflammatory zones with histiocytic cells arranged in palisades...
October 1981: Journal de Radiologie
I D Young, R N Clark, P N Manley, A Groll, J B Simon
A 31-yr-old man presented with the Budd-Chiari syndrome. A liver biopsy specimen demonstrated noncaseating centrilobular granulomas and an idiopathic necrotizing granulomatous venulitis involving hepatic vein radicles with superimposed thrombotic occlusion. High-dose prednisone therapy produced dramatic clinical improvement with resolution of the hepatomegaly, ascites, and portal hypertension and normalization of the hepatic venous angiogram. A repeat liver biopsy specimen showed resolution of the venulitis and disappearance of the hepatic vein thrombosis...
February 1988: Gastroenterology
M Petri, E Barr, K Cho, E Farmer
A 24-year-old black woman with a history of pulmonary and hepatic sarcoidosis followed by foot drop presented with uveitis, eosinophilia, leg ulcers, and sinus opacification. Biopsy of the leg ulcer and review of the past lung biopsy revealed numerous epithelioid noncaseating granulomas and granulomatous vasculitis. Although her clinical presentation raised the possibility of Wegener's granulomatosis, the many discrete granulomas and lack of necrosis on her biopsies were more in favor of sarcoidosis. Although granulomatous vasculitis has been reported as part of necrotizing sarcoid granulomatosis, our patient was unique in the extent and type of her extrapulmonary symptomatology...
July 1988: Journal of Rheumatology
C M Berlin, D K Boal, R J Zaino, S R Karl
A patient is described who presented with a 1-month history of daily fever to 38.8 degrees C. There was no sign of joint pain or swelling and no skin rash. The patient had impressive hepatomegaly without splenomegaly. The only abnormal laboratory test was a sedimentation rate of 120 mm/hr. Ultrasound examination showed hypoechoic foci throughout the liver. These foci were confirmed by CT scan, which showed multiple well-marginated lesions of decreased attenuation and variable size throughout the right and left lobes of the liver...
June 1990: Clinical Pediatrics
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