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Nodular form of local hepatic tuberculosis: case report
P Herman1, V Pugliese, R Laurino Neto
1Department of Gastroenterology, Hospital das Clínicas Medical School, University of São Paulo, Brazil.
The Journal of Tropical Medicine and Hygiene
|April 1, 1995
Summary
Nodular hepatic tuberculosis (TB) is rare, presenting as liver lesions without other TB signs. Diagnosis often requires histological examination after initial misdiagnosis as tumors or abscesses.
Area of Science:
- Hepatology
- Infectious Diseases
- Pathology
Background:
- Hepatic tuberculosis (TB) is uncommon, with the nodular form being exceptionally rare.
- Nodular hepatic TB is characterized by tumor-like tuberculomas or abscesses without extrahepatic disease.
- Fewer than 23 cases of isolated nodular hepatic TB have been documented globally since 1950.
Observation:
- This report details an additional case of multiple tuberculous abscesses in the liver.
- The patient's condition was initially misdiagnosed as hepatic abscesses.
- Intraoperative evaluation suggested a liver tumor, highlighting diagnostic challenges.
Findings:
- Histological examination confirmed the diagnosis of hepatic tuberculosis.
- Acid-fast bacilli were identified, confirming the tuberculous etiology.
- In 19 of 23 previously reported cases, diagnosis was only achieved via histology after laparotomy.
Implications:
- This case underscores the diagnostic difficulties associated with nodular hepatic TB.
- Early and accurate diagnosis is crucial for effective treatment of hepatic tuberculosis.
- Histopathological analysis remains the gold standard for diagnosing rare forms of hepatic TB.