granulomatöse Lebererkrankungen
Extrapulmonale
Sarkoidose bei einem 36jährigen Mann. Befall von Leber und Milz sowie der Lunge. Die Computertomographie axial zeigt multiple hypodense Herde, die primär an ein Malignom denken ließen, zumal die Befunde in der PET-CT stark stoffwechselaktiv waren.
Granulomatous
hepatitis due to Bartonella henselae infection in an immunocompetent patient. Abdominal CT image demonstrating a large mass lesion in the right hepatic lobe.
Hepatic
tuberculosis: a multimodality imaging review. Coronal-oblique and coronal CT images in a patient with tubercular cholangitis displaying thickening and stricture of the extrahepatic common duct (arrows) with upstream intrahepatic biliary dilatation. The presence of hepatic calcifications (dotted arrows) help exclude cholangiocarcinoma and instead consider tuberculosis in appropriate clinical settings
Extrapulmonary
tuberculosıs: an old but resurgent problem. A coronal contrast-enhanced CT image of a 43-year-old male shows multiple hypodense lesions (arrows) in the liver and spleen. Hepatic and splenic TB
Sarcoidosis
(abdominal manifestations) • Hepatic and splenic sarcoidosis - Ganzer Fall bei Radiopaedia
Disseminated
histoplasmosis in an immunocompetent individual diagnosed with gastrointestinal endoscopy: a case report. a Increased FDG uptake in liver and spleen; the length of liver was 245.543 mm and the length of spleen was 187.935 mm in the 18F-FDG PET/CT images before intervention. b esophageal mucosa was covered consecutive sheets of white bean curd-like substance under gastrointestinal endoscopy. c colon mucosa studded with protuberant lesions with central depression and erosion under gastrointestinal endoscopy
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
- sarcoidosis: hepatic manifestations of sarcoidosis
- tuberculosis: hepatic manifestations of tuberculosis
- histoplasmosis: hepatic manifestations of histoplasmosis
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.
Siehe auch:
- Sarkoidose der Leber
- Tuberkulose der Leber
- Bartonella henselae
- granulomatöse Erkrankungen der Milz
- Histoplasmose der Leber
und weiter:
Assoziationen und Differentialdiagnosen zu granulomatöse Lebererkrankungen: 
