*3.2.1 Chronic gastrointestinal and chronic biliary diseases*

Granulomas have been reported in a small minority of patients with ulcerative colitis, Crohn's disease, and idiopathic eosinophilic gastroenteritis. It is unclear whether the granulomas associated with chronic idiopathic inflammatory bowel disease could be due to diseases such as primary sclerosing cholangitis or an adverse drug reaction. Granulomas may also be a feature of idiopathic eosinophilic enteritis involving the hepatobiliary tree by the disease.

Granulomas are reported very frequently (more than 50% in many series) in primary biliary cirrhosis cases. They may be portal or lobular, but are often associated with duct lesions. However, granulomas are also seen in a minority of cases in primary sclerosing cholangitis, in which they are usually well formed and non-necrotizing.
