Hepatic granuloma in Saudi Arabia: a clinicopathological study of 59 cases.

The identification of hepatic granuloma (HG) as a histiocytic or epithelioid cell collection is generally an easy task for the pathologist. However, most workers agree that arriving at a specific etiologic diagnosis, based solely on the morphology of the granuloma, may prove quite a tedious exercise. Of 404 histologically reviewed liver biopsies from 404 patients, 40 were normal, 62 showed carcinoma, and 243 revealed evidence of either acute or chronic nongranulomatous liver disease (NGLD). The remaining 59 biopsies had HG, constituting an incidence figure of 14.6%. The latter 59 patients qualified for further clinicopathological analysis, which constituted the material for this study. The HG was due to schistosomiasis in 32, tuberculosis in 19, brucellosis in four, drugs in two, and to typhoid and ruptured fat cysts (lipogranuloma) in one patient each. The study was done to delineate the histological and other features that might be of value in identifying the etiology of HG.