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Severe granulomatous hepatitis with accompanying lymphocytic infiltrates, compatible with sarcoidosis affectation of the liver.
58 years
Increase in cholestatic liver parameters and fibro-scan values.
Liver biopsies exhibiting portal histio-, lymphocytic infiltrates and moderate to severe portal tract fibrosis. There are several epitheliod granulomas in and around the portal tracts. Extensive scarring of granulomas is also present.
Immunohistochemistry and Ziehl-Neelsen Stain are both negative for tuberculosis.
Septated granulomas are in keeping with sarcodosis and speak against tuberculosis. In few patients with sarcoidosis, progressive liver disease with portal hypertension and ascites, in absence of cirrhosis, ensues.
Ishak KG: Mayo Clin Proc, 1998; 73:467-472
Michaƫl Huguenin, University of Basel
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