Granulomata are benign liver masses which are associated with chronic inflammatory liver diseases. They are particularly associated with primary biliary cirrhosis, sarcoidosis or TB. They may be multiple and small, in which case the liver often looks coarse and hyperechoic. More often they are small discrete lesions which may be hypo- or isoechoic, sometimes with a hypoechoic rim like a target, or calcified with distal shadowing (Fig. Below). They can undergo central necrosis. Differential diagnoses include metastases or regenerating nodules.
A calcified granuloma demonstrates