title: [Tertiary gummatous syphilis of the liver--an unexpected disease today. Report of two cases].
abstract: Today the luetic hepatitis and gummata of liver are very rare manifestations of a tertiary syphilis because of the antibiotic therapy. Therefore a luetic involvement of liver is a most unexpected and at first mostly misinterpreted finding. In the both represented cases foci in the liver were present, which were suspicious for a metastasizing malignoma and set off the search for an unknown primary tumor. In liver biopsies no malignant process was seen, but necroses with a granulomatous reaction at the border were found which were classifiable definitively only after serological investigations as gummata of liver. Especially by the presence of an additionally reactive hepatitis in the remaining liver parenchyma, possibly with some sarcoid-like granulomas, a tertiary gummatous syphilis should be taken into consideration. The regression of gummata in sonography and computertomography as well as the return to normal of the laboratory findings are important parameters in the follow-up to confirm the diagnosis under antibiotic therapy. The described cases stress the importance that even today the tertiary lues should be taken into consideration by liver foci of unknown origin and should be excluded serologically.
authors.affiliation: Pathologisches Institut, Universität Würzburg.
authors.forename: J
authors.initials: J
authors.lastname: Dämmrich
authors.forename: W
authors.initials: W
authors.lastname: Fischbach
authors.forename: J
authors.initials: J
authors.lastname: Mössner
authors.forename: H W
authors.initials: HW
authors.lastname: Altmann
mesh_terms: D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D006505:Hepatitis / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D010535:Laparoscopy; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013587:Syphilis / Q000000981:diagnostic imaging* / Q000473:pathology; D013588:Syphilis Serodiagnosis; D014463:Ultrasonography
vernacular_title: Die tertiäre gummatöse Lues der Leber--eine heute unerwartete Erkrankung. Bericht über zwei Fälle.