Idiopathic Granulomatous Hepatosplenic Lesion in a Case of Chronic Liver Disease

Granulomatous liver disease is common and can indicate underlying systemic issues. Liver biopsy findings may confuse clinicians. Some patients have abnormal liver panels without symptoms, while others show systemic manifestations. Identifying the underlying cause allows proper treatment, but in some cases, even extensive workup fails to provide a diagnosis, leading to frustration. Here, we present a similar case of chronic liver disease with hepatosplenic granulomas where the diagnosis remains elusive despite an extensive workup.