Hepatic sarcoidosis

Hepatic sarcoidosis, also liver sarcoidosis, is involvement of the liver by the disease sarcoidosis.

General

• Approximately 12% of individuals with sarcoidosis have liver involvement.

Microscopic

Features:

• Well-formed non-necrotizing granulomas.

DDx:

• Drug induced liver disease.
• Primary biliary cholangitis.
• Infection.
  • Tuberculosis.
  • Histoplasmosis.

Hepatic sarcoidosis in a patient with previously known sarcoidosis. At low power markedly distorted parenchyma is highlighted by seeing the minor component of unaffected cores [parallel to double headed arrowsD] (Row 1 Left 20X). All but the lower left part is affected by a large granuloma strewing Touton body giant cells [arrows] (Row 1 Right 100X). PAS without diastase shows granulomas separated by a small column of hepatocytes (Row 2 Left 200X). Trichrome here shows the extensive fibrosis associated with the granulomatous inflammation in this case(Row 2 Right 200X). Trichrome here demonstrates a utility in picking up giant cells [arrows], whose cytoplasm often stains differently than the surrounding fibrosis (Row 3 Left 200X). As shown by this trichrome stained image, most triads showed fibrosis; none showed involvement by granuloma or increased chronic stromal inflammation (Row 3 Right 200X).

See also

• Medical liver disease.