hepatic and biliary disorders
Hepatic Granulomas
Introduction
Hepatic granulomas have numerous causes and are usually asymptomatic. However, the underlying disorder may cause extrahepatic manifestations, biliary obstruction, hepatic inflammation, fibrosis, portal hypertension, or a combination. Diagnosis is based on liver biopsy, but biopsy is necessary only if a treatable underlying disorder (eg, infection) is suspected or if other liver disorders need to be ruled out. Treatment depends on the underlying disorder. Hepatic granulomas, although sometimes insignificant, more often reflect clinically relevant disease. The term granulomatous hepatitis is often used to describe the condition, but the disorder is not true hepatitis, and the presence of granulomas does not imply hepatocellular inflammation. 