Ann Hepatobiliary Pancreat Surg.  2019 Feb;23(1):80-83. 10.14701/ahbps.2019.23.1.80.

Primary hepatic tuberculosis: A rare occurrence

• Niyogi D
• Goel M
• Shinde RS
• Patkar S

• KMID: 2439052
• DOI: http://doi.org/10.14701/ahbps.2019.23.1.80

Abstract

Primary hepatic tuberculosis is a rare entity and can closely mimic malignancy with respect to clinical presentation and imaging features. We identified five patients at a high volume tertiary care cancer center, whose clinical features and imaging closely mimicked primary liver malignancy or metastases but final histopathology was suggestive of hepatic tuberculosis. Three patients underwent a surgical resection whereas two were diagnosed on a biopsy. Anti-tuberculosis therapy was started for all the patients which was well tolerated. All patients are doing well at the time of the last follow up. This case series stresses the importance of having a high index of suspicion and preoperative biopsy in cases where imaging features are equivocal.

Keyword

Primary hepatic tuberculosis; Mimic; Malignancy

MeSH Terms

Biopsy
Follow-Up Studies
Humans
Liver
Neoplasm Metastasis
Tertiary Healthcare
Tuberculosis, Hepatic*

Figure

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  Fig. 1 Positron-emission tomography-computed tomography image of case 2, showing intense fluorodeoxyglucose uptake in the liver lesion.

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  Fig. 2 Contrast-enhanced computed tomography image of case 3, showing enhancing lesion in left lobe of the liver.

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  Fig. 3 Typical morphological features of tubercular granuloma on electron microscopy showing Langhans giant cell, necrosis and a biliary radicle (H&E, 10×).

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