Liver adenoma with granulomas. The appearance of granulomas in oral contraceptive-related hepatocellular adenoma and in the surrounding nontumorous liver.

A 31-year-old woman who had taken oral contraceptives regularly for seven years was found to have a hepatocellular adenoma in the left lobe of her liver. An unusual microscopic feature of the resected specimen was the presence of numerous noncaseating, epithelioid granulomas in both the adenoma and the surrounding nontumorous liver. The literature contains brief mentions of granulomas occurring within an occasional hepatocellular adenoma, but a search uncovered no reports of granulomas occurring in both the tumor and the surrounding nontumorous liver. This further evidence of the occurrence of epithelioid granulomas with hepatocellular adenomas suggests a possible relationship between tumor antigens and the granulomatous response.