Hepatic granulomas develop through the interactions of t lymphocytes and macrophages, with the integral involvement of t-helper (t(h)) 1 or t(h)2 pathways or both, depending on the specific granulomatous disease hepatic granulomas may be manifested clinically by elevated levels of serum alkaline phosphatase and g-glutamyltransferase enzymes. Liver granuloma differential diagnosis. The morphology and location of granulomas can help with a differential diagnosis important morphological features include the presence or absence of necrosis, the nature of the infiltrate and surrounding biopsy specimen, and the presence of organisms or foreign material, for example, schistosome eggs or fungal organisms 6 although granulomas can be located throughout the hepatic lobule, most.
liver granuloma differential diagnosis
Hepatic granulomas have many causes (see table causes of hepatic granulomas); drugs and systemic disorders (often infections) are more common causes than primary liver disordersinfections must be identified because they require specific treatments tuberculosis and schistosomiasis are the most common infectious causes worldwide; fungal and viral causes are less common. The morphology of granulomas is not specific enough to identify the cause, although it can help in developing a differential diagnosis. for example, the presence of necrosis or caseation points to infection with mycobacterium tuberculosis.poorly formed granulomatous reaction without necrosis is typical in patients with defective immune systems such as patients with aids..
0 comments:
Post a Comment