granulomatous hepatitis

Granulomatous hepatitis refers to an inflammatory liver disease associated with granuloma formation in the liver. These can be caseating or non-caseating.

Pathology

Associations

It can be associated with a wide variety of conditions, which most commonly includes

The diagnosis of granulomatous hepatitis is based solely on a finding of granulomas in the liver tissue.

Radiographic features

General

Hepatic granulomas usually appear as discrete, sharply defined nodular lesions within the liver.

MRI

Granulomatous hepatitis can have spectrum of MRI features. They are usually seen as nodules ranging around 0.5-4.5 cm in diameter .

Reported signal characteristics include:

  • caseating granulomas
    • T1: low signal
    • T2: intermediate and high signal
    • T1 C+ (Gd): variable
  • non caseating granulomas
    • T1: intermediate signal
    • T2: intermediate signal
    • T1 C+ (Gd): increased enhancement on arterial phase images with persistent enhancement in delayed images.

Ancillary extrahepatic features include portal lymph nodes and splenomegaly.

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