Hepatic lipogranulomas in patients with chronic liver disease: association with hepatitis C and fatty liver disease.
OBJECTIVE
To study the significance and clinical implication of hepatic lipogranuloma in chronic liver diseases, including fatty liver disease and hepatitis C.


METHODS
A total of 376 sequential, archival liver biopsy specimens were reviewed. Lipogranuloma, steatosis and steato-fibrosis were evaluated with combined hematoxylin and eosin and Masson's trichrome staining.


RESULTS
Fifty-eight (15.4%) patients had lipogranuloma, including 46 patients with hepatitis C, 14 patients with fatty liver disease, and 5 patients with other diseases. Hepatic lipogranuloma was more frequently seen in patients with hepatitis C (21%) and fatty liver disease (18%), and its incidence was significantly higher than that in control group (P < 0.0002 and P < 0.007, respectively). In addition, 39 out of the 58 patients with lipogranuloma were associated with steatosis and/or steato-fibrosis. Of the 18 lipogranuloma patients with clinical information available for review, 15 (83%) had risk factors associated with fatty liver disease, such as alcohol use, obesity, hyperlipidemia, and diabetes mellitus. Although the incidence of these risk factors was greater in patients with lipogranuloma than in control group (60%), it did not reach statistical significance.


CONCLUSIONS
Hepatic lipogranuloma is not limited to mineral oil use and commonly associated with hepatic steatosis, hepatitis C and fatty liver disease. With additional histological features of steato-fibrosis, lipogranuloma can also be used as a marker of prior hepatic steatosis.
Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029, USA. hongfa.zhu@mountsinai.org
Hongfa
H
Zhu
Henry C
HC
Bodenheimer
David J
DJ
Clain
Albert D
AD
Min
Neil D
ND
Theise
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D005234:Fatty Liver / Q000150:complications; D005260:Female; D006099:Granuloma / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D015994:Incidence; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D012189:Retrospective Studies; D012307:Risk Factors