Epithelioid cell granulomas in chronic hepatitis C: immunohistochemical character and histological marker of favourable response to interferon-alpha therapy.
OBJECTIVE
The clinicopathological significance of intrahepatic epithelioid cell granulomas in chronic hepatitis C was determined.


RESULTS
Granulomatous lesions were surveyed in 542 liver biopsy specimens and were immunohistochemically examined. We also tested whether this lesion is a marker of response to interferon-alpha therapy in chronic hepatitis C. Granulomatous lesions in hepatic lobules and/or portal tracts were identified in 11/542 (2%) cases with chronic hepatitis C. Granulomas were positive for HLA-DR and beta 2-microglobulin, and were surrounded by T-cells. Among them, three chronic hepatitis C cases showed portal granulomas with mild biliary epithelial damage. Bile ducts showing mild epithelial damage in chronic hepatitis C were positive for beta 2-microglobulin, but negative for HLA-DR, while both antigens were frequently expressed in damaged bile ducts in primary biliary cirrhosis (PBC). All five cases of chronic hepatitis C with granulomas who had interferon-alpha therapy and were followed up and were found to have responded well.


CONCLUSIONS
Granulomas showed the same immunohistochemical phenotypes, though the expression of HLA-DR on bile ducts in PBC but not in chronic hepatitis C suggests a different pathogenesis. Granulomas may predict a favourable response to interferon-alpha therapy in chronic hepatitis C.
Second Department of Pathology, Kanazawa University School of Medicine, Japan.
K
K
Harada
H
H
Minato
K
K
Hiramatsu
Y
Y
Nakanuma
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D005260:Female; D006099:Granuloma / Q000150:complications* / Q000276:immunology; D006684:HLA-DR Antigens / Q000032:analysis; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D007150:Immunohistochemistry; D016898:Interferon-alpha / Q000627:therapeutic use; D008107:Liver Diseases / Q000150:complications* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D001613:beta 2-Microglobulin / Q000032:analysis
D015415:Biomarkers; D006684:HLA-DR Antigens; D016898:Interferon-alpha; D001613:beta 2-Microglobulin