{
  "abstract": "Objectives: Recent data on the underlying causes of granulomatous liver injury in the United States remain limited. In this study, we provide updated tertiary care center data on the causes of hepatic granulomas and evaluate the use of histochemical and molecular diagnostics to identify infectious organisms.\n\nMethods: We retrospectively reviewed 251 cases of hepatic granulomas (2009-2024) stratified by patient immune status. Additionally, we evaluated 6-year retrospective data from 2 institutions to determine the yield of broad-range molecular testing for infectious diseases.\n\nResults: Causes of the 251 cases included idiopathic (31%), autoimmune disease (20%), steatohepatitis (19%), sarcoidosis (10%), infection (8%), and drug reaction (4%). A subset (9%) of idiopathic cases showed features highly suspicious for infection, but standard infectious stains were unrevealing, and none were initially sent for molecular testing. Retrospective evaluation of send-out pathogen molecular testing across both institutions revealed organism detection in 32% (12/37) and 50% (4/8) of highly suspicious cases, respectively. Increasing clinicopathologic suspicion correlated positively with successful molecular pathogen identification and inversely with false-positive contamination rates.\n\nConclusions: Molecular testing is frequently underused by pathologists in the workup of granulomatous hepatitis. Pathologists should proactively leverage molecular diagnostics to optimize clinical decision-making when standard histochemical stains are unrevealing.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "name": "Charles H Wang",
      "orcid": "0009-0005-2744-5653"
    },
    {
      "name": "Kathleen Byrnes"
    },
    {
      "name": "Gillian L Hale"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4dghxn1ejk59e.bib",
  "cited_by": 0,
  "doi": "10.1093/ajcp/aqag114",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13736002/",
  "id": "4dghxn1ejk59e",
  "issns": [
    "0002-9173",
    "1943-7722"
  ],
  "landing_url": "https://doi.org/10.1093/ajcp/aqag114",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "AcademicSubjects/MED00690"
    ],
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2740|Sarcoidosis and Beryllium Toxicity Research"
    ]
  ],
  "openalex": "W7225338470",
  "pdf_url": null,
  "pmcid": "PMC13736002",
  "pmid": "42985919",
  "published": "2026-11-05",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/4dghxn1ejk59e.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:21:34Z",
      "native_id": "PMC13736002",
      "source": "pmc",
      "url": "https://doi.org/10.1093/ajcp/aqag114"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Sarcoidosis and Beryllium Toxicity Research",
      "subfield": "general"
    }
  ],
  "title": "A 16-year retrospective investigation of granulomatous liver injury in immunocompetent and immunocompromised patients at a tertiary care center",
  "title_text": "A 16-year retrospective investigation of granulomatous liver injury in immunocompetent and immunocompromised patients at a tertiary care center",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:21:34Z",
  "url": "https://research.draconitic.com/paper/4dghxn1ejk59e",
  "venue": "American Journal of Clinical Pathology",
  "versions": []
}