{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T14:14:46Z","timestamp":1781100886574,"version":"3.54.1"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,5,30]],"date-time":"2018-05-30T00:00:00Z","timestamp":1527638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Hepatic granulomas have an estimated prevalence of 5% in liver biopsies, with a wide range of aetiologies globally. Our aim was to assess the clinical relevance, presenting features and underlying aetiology in a non\u2010transplant, tertiary referral centre from a western country.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>This was a retrospective, single\u2010centre review of clinical, laboratory and histological data including all adult patients for whom a liver biopsy was performed from January 1998 to December 2014. A total of 297 cases with hepatic granulomas were found in 9374 biopsies, but 57 were excluded from analysis either because they were lipogranulomas or the biopsy\/aetiological work\u2010up had not been performed at our institution. Overall, the most common aetiology was tuberculosis (35.8%), followed by primary biliary cholangitis (<jats:styled-content style=\"fixed-case\">PBC<\/jats:styled-content>) \u2013 15.0%. In 30 patients (12.5%) granulomas were classified as idiopathic. From 1998 to June 2006 there were 147 granulomas in 5304 biopsies (2.8%), a frequency that did not change significantly compared to the period from July 2006 to December 2014 (93 granulomas in 4070 biopsies, 2.3%, <jats:italic>P<\/jats:italic> &gt; 0.05). However, for the majority of cases (61.9%) there was a shift in granuloma aetiology during the former time\u2010period that infectious diseases were responsible, whereas in the latter, autoimmune liver diseases (43%) were the main aetiology. In addition, while three cases of drug\u2010induced granulomas were found from 1998 to June 2006, we report two cases in the second time\u2010period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hepatic granulomas can result from various infectious and non\u2010infectious diseases. During recent years, an epidemiological shift regarding granuloma aetiology was observed, from systemic infectious diseases to non\u2010infectious, mainly immune\u2010mediated primary liver disorders. With an appropriate work\u2010up the aetiology can be identified in the vast majority of cases (~90%), rendering its histological identification and characterisation essential, as disease\u2010specific therapies are becoming available.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.13521","type":"journal-article","created":{"date-parts":[[2018,3,31]],"date-time":"2018-03-31T10:47:32Z","timestamp":1522493252000},"page":"240-246","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Hepatic granulomas: a 17\u2010year single tertiary centre experience"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0332-3844","authenticated-orcid":false,"given":"Rui","family":"Gaspar","sequence":"first","affiliation":[{"name":"Gastroenterology Department Centro Hospitalar S\u00e3o Jo\u00e3o Faculty of Medicine of the University of Porto Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Andrade","sequence":"additional","affiliation":[{"name":"Gastroenterology Department Centro Hospitalar S\u00e3o Jo\u00e3o Faculty of Medicine of the University of Porto Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Silva","sequence":"additional","affiliation":[{"name":"Gastroenterology Department Centro Hospitalar S\u00e3o Jo\u00e3o Faculty of Medicine of the University of Porto Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando","family":"Peixoto","sequence":"additional","affiliation":[{"name":"Gastroenterology Department Centro Hospitalar S\u00e3o Jo\u00e3o Faculty of Medicine of the University of Porto Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Lopes","sequence":"additional","affiliation":[{"name":"Pathology Department Centro Hospitalar S\u00e3o Jo\u00e3o Faculty of Medicine of the University of Porto Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"Carneiro","sequence":"additional","affiliation":[{"name":"Pathology Department Centro Hospitalar S\u00e3o Jo\u00e3o Faculty of Medicine of the University of Porto Porto Portugal"},{"name":"Instituto de Patologia e Imunologia Molecular da Universidade do Porto (Ipatimup, and i3S\u2010Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade) Universidade do Porto Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Liberal","sequence":"additional","affiliation":[{"name":"Gastroenterology Department Centro Hospitalar S\u00e3o Jo\u00e3o Faculty of Medicine of the University of Porto Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme","family":"Macedo","sequence":"additional","affiliation":[{"name":"Gastroenterology Department Centro Hospitalar S\u00e3o Jo\u00e3o Faculty of Medicine of the University of Porto Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,30]]},"reference":[{"issue":"1","key":"e_1_2_6_2_1","first-page":"40","article-title":"Hepatic granulomas","volume":"30","author":"Lefkowitch JH","year":"1999","journal-title":"J. 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