A transient emergence of hepatic granulomas in a patient with chronic hepatitis B.

So far there were no reports but one on a hepatic granuloma in chronic hepatitis B virus (HBV) infection. We present a case of chronic hepatitis B with a transient emergence of hepatic granulomas. The case was a 35-year-old male who had chronic hepatitis with persistent hepatitis B surface antigen in the sera. A liver biopsy showed noncaseating granulomas in the parenchyma and a mild portal enlargement with mononuclear cell infiltration. The cellular components of the granulomas were mainly cluster of differentiation 68-positive macrophages with a few lymphocytes in the periphery. However, no granulomas were found in a liver specimen obtained three weeks after the first liver biopsy. Possible disorders causing hepatic granulomas such as tuberculosis, sarcoidosis, drugs and other infectious diseases were ruled out by clinical, serological and histopathological examination. Thus it is possible that the transient emergence of hepatic granulomas is a phenomenon related to chronic HBV infection.