Brief Article
Copyright ©2010 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Oct 28, 2010; 16(40): 5065-5069
Published online Oct 28, 2010. doi: 10.3748/wjg.v16.i40.5065
Hepatic lipogranulomas in patients with chronic liver disease: Association with hepatitis C and fatty liver disease
Hongfa Zhu, Henry C Bodenheimer Jr, David J Clain, Albert D Min, Neil D Theise
Hongfa Zhu, Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029, United States
Henry C Bodenheimer Jr, David J Clain, Albert D Min, Department of Medicine (Divisions of Digestive Diseases), Beth Israel Medical Center, Albert Einstein College of Medicine, New York, NY 10003, United States
Neil D Theise, Department of Pathology, Beth Israel Medical Center, Albert Einstein College of Medicine, New York, NY 10003, United States
Author contributions: Zhu H and Theise ND designed the study and wrote the manuscript; Bodenheimer HC Jr, Clain DJ and Min AD provided the patients’ clinical information and reviewed the manuscript.
Correspondence to: Hongfa Zhu, MD, Department of Pathology, Mount Sinai School of Medicine, 1 Gustave Levy Place, New York, NY 10029, United States. hongfa.zhu@mountsinai.org
Telephone: +1-212-2414226   Fax: +1-212-2892899
Received: February 16, 2010
Revised: April 19, 2010
Accepted: April 26, 2010
Published online: October 28, 2010
Abstract

AIM: 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.

CONCLUSION: 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.

Keywords: Lipogranuloma; Hepatitis C; Fatty liver disease; Steatosis; Steato-fibrosis