Granulomatous hepatitis refers to an inflammatory liver disease associated with granuloma formation in the liver. These can caseating or non-caseating.
It can be associated with a wide variety of conditions, which most commonly includes
- sarcoidosis: hepatic manifestations of sarcoidosis
- tuberculosis: hepatic manifestations of tuberuclosis
- histoplasmosis: hepatic manifestations of histoplasmosis
The diagnosis of granulomatous hepatitis is based solely on a finding of granulomas in the liver tissue.
Hepatic granulomas usually appear as discrete, sharply defined nodular lesions within the liver.
Granulomatous hepatitis can have spectrum of MRI imaging features. They are usually seen as nodules ranging around 0.5-4.5 cm in diameter 2.
Reported signal characteristics include:
- T1: low signal
- T2: intermediate and high signal
- T1 C+ (Gd): variable
non caseating granulomas
- T1: intermediate signal
- T2: intermediate signal
- T1 C+ (Gd): increased enhancement on arterial phase images with persistent enhancement in delayed images.
Ancillary extrahepatic features include portal lymph nodes and splenomegaly.
- 1. Mortelé KJ, Segatto E, Ros PR. The infected liver: radiologic-pathologic correlation. Radiographics. 2004;24 (4): 937-55. Radiographics (full text) - doi:10.1148/rg.244035719 - Pubmed citation
- 2. Balci NC, Tunaci A, Akinci A et-al. Granulomatous hepatitis: MRI findings. Magn Reson Imaging. 2002;19 (8): 1107-11. Pubmed citation