Multidetector CT findings of histopathologically proven peritoneal tuberculous cold abscesses

To evaluate the characteristic multidetector CT findings of peritoneal tuberculous (TB) cold abscesses.

The morphological characteristics of 48 peritoneal TB cold abscesses in 29 patients (male:female = 13:16; age range 16-75 years) were retrospectively evaluated. TB infection was histologically proven by acid fast bacilli (AFB) smear or culture, TB-polymerase chain reaction (PCR), or histopathological specimen diagnosis.

Seventeen abscesses (35.4%) were present in the right perihepatic space, 10 (20.8%) in the left subphrenic space, 6 (12.5%) in the right subphrenic space, 4 (8.3%) in the pelvic cavity, 3 (6.3%) in the left perihepatic space, 3 (6.3%) in the right lower quadrant, and so on. The abscess contents ranged from 10.4 to 61.4 Hounsfield units. Internal septa (64.6%), central necrotic lymphadenopathy (55.2%), and TB coinfections in other organs (65.5%) were observed. TB infection was histopathologically confirmed from the surgical specimens in 17 patients and other 4 patients revealed the positive TB-PCR results from the peritoneal fluid. Ten patients (34.5%) had a recent history of TB peritonitis with ascites.

Peritoneal TB cold abscesses were commonly found in the right perihepatic and subphrenic spaces and revealed higher density of internal content, frequent internal septa, central necrotic lymphadenopathy, and high TB coinfections in other organs.