Granulomatous liver disease in the small hepatic and portal veins

A 72-year-old-man had severe portal hypertension, refractory ascites, and granulomatous liver disease involving the small tributaries of the hepatic and portal veins. Granulomatous lesions were found neither in the hepatic parenchyma nor in the other organs. The diminished lumina of the affected veins and periportal fibrosis that probably resulted from the granulomatous vascular lesions seem to cause portal hypertension and refractory ascites.