[Idiopathic hepatosplenic granulomatosis]

Granulomas in the liver are identified in 3-10% of all liver biopsies. Although granulomas frequently represent a sign of either infectious or non infectious disease, 20% of the hepatic granulomas lack an identifiable etiology. These cases are defined as idiopathic granulomatous hepatitides (IG). We describe four cases of disease resembling a lymphoid malignance in which IG could be diagnosed by laboratory, radiological (XR, CT), ultrasonographic, histological and follow-up studies of the patients. We suggest that IG may be suspected in patients with granulomas in the liver, self-limited fever of unknown origin, low epatosplenomegaly, eosinophilia less than 5%, in the absence of infectious, lymphoid or sarcoid diseases. We recommend laparascopy as an important diagnostic tool.