Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA.
Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
Hepatol Commun. 2024 Mar 18;8(4). doi: 10.1097/HC9.0000000000000392. eCollection 2024 Apr 1.
A granuloma is a discrete collection of activated macrophages and other inflammatory cells. Hepatic granulomas can be a manifestation of localized liver disease or be a part of a systemic process, usually infectious or autoimmune. A liver biopsy is required for the detection and evaluation of granulomatous liver diseases. The prevalence of granulomas on liver biopsy varies from 1% to 15%. They may be an incidental finding in an asymptomatic individual, or they may represent granulomatous hepatitis with potential to progress to liver failure, or in chronic disease, to cirrhosis. This review focuses on pathogenesis, histological features of granulomatous liver diseases, and most common etiologies, knowledge that is essential for timely diagnosis and intervention.
肉芽肿是活化的巨噬细胞和其他炎症细胞的离散集合。肝肉芽肿可能是局部肝脏疾病的表现，也可能是全身性疾病的一部分，通常是感染性或自身免疫性的。肝活检是检测和评估肉芽肿性肝病所必需的。肝活检中肉芽肿的患病率从 1%到 15%不等。它们可能是无症状个体的偶然发现，也可能代表有进展为肝衰竭的潜在风险的肉芽肿性肝炎，或者在慢性疾病中发展为肝硬化。本文重点介绍了肉芽肿性肝病的发病机制、组织学特征和最常见的病因，这些知识对于及时诊断和干预至关重要。
