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Histopathology of granulomatous liver disease

A granuloma is a collection of specialized tissue macrophages known as histiocytes. There is often a lymphocytic component, either intermingled with or forming a cuff around the histiocytes, but it is the aggregation of macrophages that is required to classify an inflammatory process as granulomatous. From a morphological standpoint, granulomas may be either loose or well-formed (epithelioid) and caseating or noncaseating. Sometimes the constituent histiocytes will fuse together forming multinucleated giant cells (Fig. 1).