hepatic and biliary disorders
Hepatic Granulomas
Diagnosis of Hepatic Granulomas
Liver tests Imaging Biopsy Hepatic granulomas are suspected in patients with Conditions that commonly cause granulomas Unexplained hepatic masses found during imaging tests Abnormalities detected by an imaging test that is done to evaluate asymptomatic elevations in liver enzymes, particularly alkaline phosphatase When granulomas are suspected, Laboratory Tests of the Liver and Gallbladder are usually done, but results are nonspecific and are rarely helpful in diagnosis. Alkaline phosphatase (and gamma-glutamyltransferase) is often mildly elevated but occasionally may be markedly elevated. Other test results may be normal or abnormal, reflecting additional hepatic damage (eg, widespread hepatic inflammation due to a drug reaction). Usually, Diagnosis is based on Liver Biopsy . However, biopsy is usually indicated only to diagnose treatable causes (eg, infections) or to rule out nongranulomatous disorders (eg, In patients with constitutional or other symptoms suggesting infection (eg, Fever of Unknown Origin (FUO) [FUO]), specific measures are taken to increase the diagnostic sensitivity of biopsy for infections; eg, a portion of the fresh biopsy specimen is sent for culture, or special stains for acid-fast bacilli, fungi, and other organisms are used. Often, cause cannot be established. 