title: Fibrin Ring Granulomas in Checkpoint Inhibitor-induced Hepatitis.
abstract: Fibrin ring granulomas are an uncommon finding in liver biopsies although they have been described in liver injury secondary to several infectious and noninfectious entities, most notably Q fever. Immune checkpoint inhibitors are recent advances in cancer therapy, and stimulate the immune system to cause antitumoral effects but may also lead to adverse immune events such as hepatitis and colitis. We report 2 patients on combination ipilimumab/nivolumab who developed hepatitis and had fibrin ring granulomas in their liver biopsies.
authors: *James Homer Wright Pathology Laboratories, Massachusetts General Hospital †Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors: Jamie
authors: J
authors: Everett
authors: Amitabh
authors: A
authors: Srivastava
authors: Joseph
authors: J
authors: Misdraji
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects; D056486:Chemical and Drug Induced Liver Injury / Q000473:pathology*; D005260:Female; D006099:Granuloma / Q000139:chemically induced* / Q000473:pathology*; D006801:Humans; D000074324:Ipilimumab; D008297:Male; D008545:Melanoma / Q000188:drug therapy; D008875:Middle Aged; D000077594:Nivolumab
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D000074324:Ipilimumab; D000077594:Nivolumab