The clinical spectrum of hepatic granuloma

Hepatic granulomas diagnosed ante mortem by liver biopsy over a 9-year period at Groote Schuur Hospital, Cape Town, were reviewed. A diagnosis was made in 94% of the 116 cases studied. Tuberculosis was found to be the cause in 50% of all cases. In Black patients tuberculosis accounted for 83%. Lymphoma was a major cause in White patients, in whom it accounted for 28%. The clinical, haematological, biochemical and radiological features favouring each diagnostic category are described. The importance of follow-up and in some cases repeat biopsy is stressed.