(See also Overview of Liver Tumors Overview of Liver Tumors Liver tumors may be noncancerous (benign) or cancerous (malignant). Cancerous liver tumors are classified as primary (originating in the liver) or metastatic (spreading from elsewhere in the... read more .)
Granulomas themselves usually cause no problems, but the disorders that cause them may.
Granulomas have many causes. The most common are
Certain drugs
Certain disorders that affect the whole body (often infections, such as tuberculosis Tuberculosis (TB) Tuberculosis is a chronic contagious infection caused by the airborne bacteria Mycobacterium tuberculosis. It usually affects the lungs, but almost any organ can be involved. Tuberculosis... read more
and schistosomiasis Schistosomiasis Schistosomiasis is infection caused by certain flatworms (flukes), called schistosomes. People acquire schistosomiasis by swimming or bathing in fresh water that is contaminated with the flukes... read more )Hodgkin Hodgkin Lymphoma Hodgkin lymphoma is a cancer of a type of white blood cell called lymphocytes and is distinguished from other lymphomas by the presence of a particular kind of cancer cell called a Reed-Sternberg... read more and non-Hodgkin lymphomas Non-Hodgkin Lymphomas Non-Hodgkin lymphomas are a diverse group of cancers of types of white blood cell called lymphocytes. Often, lymph nodes in the neck, under the arms, or in the groin enlarge rapidly and painlessly... read more
Granulomas occur less commonly in liver disorders but may be present in primary biliary cholangitis Primary Biliary Cholangitis (PBC) Primary biliary cholangitis (PBC) is inflammation with progressive scarring of the bile ducts in the liver. Eventually, the ducts are blocked, the liver becomes scarred, and cirrhosis and liver... read more .
Granulomas may form when cells of the immune system gather to respond to irritants or to defend the body against foreign substances in the liver. Usually, liver function is unaffected, although liver-related blood tests may be abnormal. Granulomas may form as part of widespread inflammation, which may be a reaction to a drug or to an infection. If inflammation is widespread, the liver may malfunction. Rarely, the inflammation results in scar tissue and high blood pressure in the veins that bring blood from the intestine to the liver (called portal hypertension Portal Hypertension Portal hypertension is abnormally high blood pressure in the portal vein (the large vein that brings blood from the intestine to the liver) and its branches. Cirrhosis (scarring that distorts... read more ).
Symptoms of Hepatic Granulomas
Granulomas themselves typically cause no symptoms. The liver may enlarge slightly, and mild jaundice Jaundice in Adults In jaundice, the skin and whites of the eyes look yellow. Jaundice occurs when there is too much bilirubin (a yellow pigment) in the blood—a condition called hyperbilirubinemia. (See also Overview... read more 
(a yellowish discoloration of the skin and the whites of the eyes) may develop. Other symptoms, if they develop, result from the disorder causing the granulomas. Granulomas caused by sarcoidosis may disappear spontaneously or persist for years without causing any noticeable symptoms.
Idiopathic granulomatous hepatitis is a rare disorder of unknown cause. It causes granulomas, fever, muscle aches, and fatigue. These symptoms often occur intermittently for years.
Diagnosis of Hepatic Granulomas
Liver imaging tests
Sometimes liver biopsy
Doctors ask questions about drug use and other disorders that could cause granulomas. Doctors also do blood tests to evaluate the liver Liver Blood Tests Liver tests are blood tests that represent a noninvasive way to screen for the presence of liver disease (for example, viral hepatitis in donated blood) and to measure the severity and progress... read more and imaging tests Imaging Tests of the Liver and Gallbladder Imaging tests of the liver, gallbladder, and biliary tract include ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), endoscopic retrograde cholangiopancreatography... read more , such as ultrasonography, computed tomography (CT), or magnetic resonance imaging (MRI). However, the results may be inconclusive. Biopsy Biopsy of the Liver Doctors can obtain a sample of liver tissue during exploratory surgery, but more often they obtain a sample by inserting a hollow needle through the person's skin and into the liver. This type... read more (removal of a small sample of liver tissue with a needle for examination under a microscope) may be needed to confirm the diagnosis.
Other tests, such as cultures, may be needed to identify the cause.
Treatment of Hepatic Granulomas
Treatment of underlying disorder
For sarcoidosis, sometimes corticosteroids
The underlying disorder is treated. Stopping a drug that can cause granulomas or treating an infection usually causes the granulomas to disappear.
Sometimes corticosteroids are used to treat sarcoidosis Sarcoidosis Sarcoidosis is a disease in which abnormal collections of inflammatory cells (granulomas) form in many organs of the body. Sarcoidosis usually develops in people aged 20 to 40 years, most often... read more 
, but whether they prevent the disorder from progressing is uncertain.
More Information
The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.
American Liver Foundation: Hosts community education programs that give an overview of all aspects of liver disease and wellness. Also provides access to support groups, information on finding a physician, and opportunities to participate in clinical trials.
