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- Title
Hepatic Granulomata.
- Authors
Berlin Jr, Cheston M.; Boal, Danielle K.; Zaino, Richard J.; Karl, Stephen R.
- Abstract
A patient is described who presented with a 1-month history of daily fever to 38.8°C. There was no sign of joint pain or swelling and no skin rash. The patient had impressive hepatomegaly without splenomegaly. The only abnormal laboratory test was a sedimentation rate of 120 mm/hr. Ultrasound examination showed hypoechoic foci throughout the liver. These foci were confirmed by CT scan, which showed multiple well-marginated lesions of decreased attenuation and variable size throughout the right and left lobes of the liver A liver biopsy specimen showed large nodules that were yellow and gritty in texture. Microscopic examination of biopsy specimens of these nodules showed extensive areas of necrotizing granulomatous inflammation with palisading histiocytes and occasional giant cells surrounded by necrotic foci. There was an associated fibroinflammatory infiltrate. The patient was treated with a nonsteroidal anti-inflammatory agent with prompt cessation of fever. A repeat CT examination of the liver alter 14 months of treatment showed only mild hepatomegaly and a normal liver parenchyma. The focal lesions had disappeared. This is a case of hepatic granulomata in a child showing features of necrotizing inflammation.
- Subjects
FEVER; SYMPTOMS; INFLAMMATION; CLINICAL pathology; ANTI-inflammatory agents; THERAPEUTICS; DIAGNOSTIC imaging; NONSTEROIDAL anti-inflammatory agents
- Publication
Clinical Pediatrics, 1990, Vol 29, Issue 6, p339
- ISSN
0009-9228
- Publication type
Article