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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A survey of the laparoscopic findings in such important focal diseases of the liver as metastasis, tumours, cysts and abscesses is given. Among the granulomatous changes, sarcoidosis, lymphogranulomatosis, tuberculosis and reticulosis deserve special attention. Definitive differentiation is, as a rule, only possible after carrying out a histological examination. In numerous infectious diseases, small granulomatous changes can be observed in conjunction with a so-called reactive hepatitis. Industrial noxae (e.g. beryllium, asbestos, silicates, and others) can also induce granulomatosis.
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PMID:[Focal liver diseases--laparoscopic aspects]. 13 Nov 1

The study of human lymphoid cell differentiation markers has recently yielded many insights into the pathogenesis of certain diseases which primarily affect the immune system. The application of these markers has, however, generated a host of new questions. Both technical difficulties and uncertainties concerning the significance of particular markers limit their routine application at the present time. Indeed, many studies in the literature, both in the diseases reviewed above, and perhaps to a greater degree in other conditions ('autoimmune' diseases, sarcoidosis, hepatitis and various infections) require re-evaluation in the light of recently increased sophistication about cell surfaces. Because of these qualificatins, the application of multiple characterizations of lymphoid cells using independent methodologies is necessary before any firm conclusions can be drawn in a particular clinical or experimental situation.
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PMID:Human lymphocyte differentiation markers and their application to immune deficiency and lymphoproliferative diseases. 33 21

An etiologic study was made of 107 cases of granulomatous hepatitis which were observed in a Department of Internal Medicine between January, 1971 and December, 1977 (excluding the hepatobiliary diseases). The most common etiology was tuberculosis (30 cases, 28 percent) followed by sarcoidosis (19 cases, 17.7 percent), Mediterranean exanthematous fever (13 cases, 12.1 percent), brucellosis (8 cases, 7.4 percent) typhoid fever (7 cases, 6.5 percent) and the idiopathic forms (8 cases, 7.4 percent). A lower rate of incidence was among Hodgkin's disease, toxoplasmosis, adenocarcinomas, leprosy, and those of unknown etiology, classified in this way because the study and follow-up of the patients could not be completed. There were, moreover, individual cases caused by mononucleosis, BCG reaction, hypogammaglobulinemia, celiac disease, and temporal arteritis. From a clinical point of view 50 percent of the patients had hepatomegaly and moderate disturbance of the liver enzymes. The most important enzymatic increases were detected in the cases caused by brucellosis; in the cases which were secondary to sarcoidosis the liver enzymes were normal. A comparison is established between the etiologic incidence of the present series and of others published in the literature. The causes and diagnostic problems of this type of lesion are discussed.
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PMID:[Granulomatous hepatitis. Etiologic study of 107 cases (author's transl)]. 45 94

Disseminated visceral giant cell arteristic, a previously unknown entity, was observed in four autopsied patients, all men, aged 33, 67, 59 and 45 years. None of the patients had temporal arteritis, collagen disease, sarcoidosis, hepatitis or other infections, and vasculitis was diagnosed only after death. All had giant cell arteritis of extracranial arteries and arterioles in at least three of the following organs: the heart, lungs, kidneys, liver, pancreas, and stomach in various combinations. Despite some histopathologic similarities, disseminated visceral giant cell arteritis can be distinguished from other necrotizing and granulomatous vasculitides by the type of vessels principally affected and the presence or absence of giant cells, vascular fibrinoid necrosis and eosinophilic infiltrates. The observations suggest that it is a distinctive type of systemic vasculitis.
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PMID:Disseminated visceral giant cell arteritis: histopathologic description and differentiation from other granulomatous vasculitides. 63 44

Individual observers interpreted images in order to assess their accuracy and sources of error. Seventy-six liver images were presented to nine readers for interpretation. Readers of differing experience participated in the study: four radiology residents, three fellows in nuclear medicine, and two full-time nuclear medicine physicians. A higher incidence of false-positive reading was more common in inexperienced observers (11-50%) and the most correct readings were obtained by staff physicians (88% overall percentage accuracy). Heterogeneity in radionuclide uptake was the most frequently ill-defined nature was the most common false-positive finding in normal cases. Early stages of cirrhosis, mild hepatitis, and rare diseases such as hepatic sarcoidosis were difficult to detect. Skill of interpretation improved with experience, especially in judging heterogeneity of an ill-defined nature, and the rate of accurate readings was proportional to the level of training of the observer.
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PMID:Interpretation of radionuclide liver images: do training and experience make a difference? 111 Mar 99

Granulomatous hepatitis with non-caseous epithelioid-cell granulomas (43 cases, 86%) and non-specific reactive hepatitis (7 cases, 14%) were observed in liver biopsies of 50 patients with sarcoidosis. Three types of granulomas are distinguished: macrophagal, florid and fading epithelioid-cell granulomas which are consequent stages of the granuloma transformation. Fibrosis arises in the macrophagal granuloma, is increasing in both epithelioid-cell granulomas and is ended by a formation of a small scar. Nonspecific liver changes were also found (hydropic and fat hepatocyte degeneration, hypertrophy and proliferation of the stellate reticulo-endotheliocytes, sinuses capillarization, lymphoid-histiocytic infiltration of the intralobular stroma and portal tract, step-like necrosis which are probably induced by the action of the sarcoidosis unknown etiological factor.
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PMID:[Morphologic features of the liver in sarcoidosis]. 147 29

Sarcoidosis and malignant lymphoma can occur in the same patient; sarcoidosis appears first, the malignant lymphoma follows later. The case histories of three patients illustrate what Brinker first coined as the "sarcoidosis-lymphoma syndrome". In two patients a pulmonary sarcoidosis stage I was diagnosed over 30 years respectively 4 years prior to the histological diagnosis of highly malignant Non-Hodgkin lymphoma. The third patient suffered from generalized sarcoidosis with splenomegaly, , granulomatous hepatitis and interstitial lung disease, in addition to which a lymphoproliferative syndrome was diagnosed. Comparing the pathogenesis of malignant lymphoma and sarcoidosis, parallels such as T-cell dysfunction, which probably facilitates malignant transformation of B-cells, become apparent. In both diseases the transforming gene could be the Ebstein-Barr virus.
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PMID:[The "sarcoidosis-lymphoma syndrome"--a lymphocyte dysregulation?]. 149 11

Today the luetic hepatitis and gummata of liver are very rare manifestations of a tertiary syphilis because of the antibiotic therapy. Therefore a luetic involvement of liver is a most unexpected and at first mostly misinterpreted finding. In the both represented cases foci in the liver were present, which were suspicious for a metastasizing malignoma and set off the search for an unknown primary tumor. In liver biopsies no malignant process was seen, but necroses with a granulomatous reaction at the border were found which were classifiable definitively only after serological investigations as gummata of liver. Especially by the presence of an additionally reactive hepatitis in the remaining liver parenchyma, possibly with some sarcoid-like granulomas, a tertiary gummatous syphilis should be taken into consideration. The regression of gummata in sonography and computertomography as well as the return to normal of the laboratory findings are important parameters in the follow-up to confirm the diagnosis under antibiotic therapy. The described cases stress the importance that even today the tertiary lues should be taken into consideration by liver foci of unknown origin and should be excluded serologically.
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PMID:[Tertiary gummatous syphilis of the liver--an unexpected disease today. Report of two cases]. 153 93

Although several studies have shown that sarcoidosis and tuberculosis are the most common causes of granulomatous hepatitis (GH), these studies were biased because results of unselected liver biopsies and autopsy reports were included. We reviewed the medical records of patients diagnosed with GH at the Mayo Clinic between September 1976 and October 1985 for the current study. Our study group consisted of 45 women and 43 men (mean age, 54.2 years). Overall, 65 patients (74%) were symptomatic; the rest had only liver enzyme abnormalities. The mean duration of symptoms was 19.1 months. Assessment of these patients and a comprehensive workup for infectious agents or other causes revealed idiopathic GH confined to the liver in 50%, sarcoidosis with confirmed extrahepatic disease in 22%, drug-related GH in 6%, tuberculosis in 3%, and other causes in 19%. Our study found a much higher frequency of idiopathic GH than previously published reports, and it represents the largest number of cases of idiopathic liver granulomas reported in a single series.
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PMID:Granulomatous hepatitis: a retrospective review of 88 cases at the Mayo Clinic. 192 1

Between April 1976 and March 1987, in an Internal Medicine department some 300 unguided percutaneous liver biopsies were performed, using the Tru-Cut excision needle. The procedure contributed to the diagnosis in 76.2% of the cases. In alcoholism-related pathology with its specific lesions, liver biopsy is particularly useful in diagnosing incipient fatty degeneration and hepatitis and helps in the prognosis of cirrhosis. In chronic hepatitis, it asserts the diagnosis and provides aetiological and prognostic data. The finding of granulomas at histology sometimes clinches a hitherto undecided diagnosis : sarcoidosis or tuberculosis? The diagnosis of drug-induced hepatitis rests on convergent clinical, biochemical and histological elements. In blood diseases, liver biopsy is of interest on three scores: it shows whether or not the liver is involved, detects intercurrent complications and evaluates the extent of the lesions before treatment. When performed after ultrasonography, it enables intrahepatic cholestasis to be recognized and extrahepatic cholestasis, unidentified by ultrasounds, to be suspected. In primary biliary cirrhosis, it confirms the diagnosis and informs on the severity and progressiveness of the disease. In hepatic cancers, liver biopsy has recently been superseded by computerized tomography and ultrasonography. Finally, it largely contributes to the diagnosis of overload disease and evaluates their activity and their impact on the liver.
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PMID:[Value of liver biopsy in internal medicine. Apropos of a series of 300 puncture biopsies]. 239 71


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