**1. Introduction**

Liver granulomas may appear as either a primary condition or secondary to systemic disease [1]. They consist of modified macrophages and other inflammatory cells that adhere due to antigenic stimulation. If there is liver inflammation within or surrounding these granulomas, the term used is granulomatous hepatitis.

The prevalence of liver granulomas is as high as 15% in biopsy specimens in the general population [2], with a higher frequency (up to 75%) in special populations like HIV-infected patients and patients with prolonged fever of unknown etiology [3].

Common causes of liver granulomas include primary biliary cirrhosis, sarcoidosis, infectious diseases (*Mycobacterium tuberculosis*, Listeria, Histoplasma, Schistosoma and hepatitis C virus), drugs and malignancies [1]. However, up to 36% of all liver granulomas are of unknown etiology [4].

Granuloma formation takes place during a chronic inflammation reaction, involving epithelioid cells, lymphocytes, monocytes and plasma cells, recruited under the influence of T-cell interleukins [1]. The reaction is consistent with a delayed hypersensitivity cellular immune response to pathogenic material.
