Parameters which Can Differentiate Patients with “Idiopathic” from Patients with Lymphoma‐Induced Liver Granulomas

Dan Aderka, Mordechai Kraus, Abraham Weinberger, Jack Pinkhas

Research output: Contribution to journalArticlepeer-review

Abstract

Part of the “idiopathic” liver granulomas prove finally to be caused by infection, sarcoidosis, or malignancy. We looked for the initial admission parameters which may differentiate the idiopathic from the malignancy related granulomas. Patients with idiopathic granulomatous hepatitis had smaller spleen than of lymphoma related granulomas (2.15 ± 2 versus 9.5 ± 4.8 cm below the costal margin, p < 0.01), smaller liver (2.61 ± 2 cm versus 6.5 ± 4.0 cm, p < 0.05), a lower percent of eosinophils (2.3 ± 1.4 versus 6.2 ± 3.5%, p < 0.05) and unlike patients with lymphoma, their fever did not persist beyond 4 wk (p = 0.03). Indeed, if the fever remitted spontaneously, it was likely that a benign condition was responsible for the granulomas (p < 0.025). If fever persisted (4 wk), a liver or a spleen extending more than 4 cm below the costal margin and 4% eosinophils were attributed 1 point each; a score of 2 points had a specificity of 80 and a 100% sensitivity in detecting patients with lymphoma related liver granulomas. It is concluded that the size of the liver and spleen, the percentage of eosinophils, and the persistance of fever may differentiate between patients with idiopathic‐ versus lymphoma‐related granulomatous hepatitis.

Original languageEnglish
Pages (from-to)1004-1007
Number of pages4
JournalAmerican Journal of Gastroenterology
Volume80
Issue number12
DOIs
StatePublished - Dec 1985

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