[Periportal adenitis secondary to abdominal tuberculosis. A CT study]

Area of Science:

• Radiology
• Infectious Diseases
• Hepatology

Background:

• Tuberculosis (TB) can manifest in various organs, but isolated periportal tuberculous adenitis is exceptionally rare.
• Accurate diagnosis of rare tuberculous presentations is crucial for timely and effective treatment.

Observation:

• Computed tomography (CT) is the principal imaging modality for identifying and assessing periportal tuberculous adenitis.
• CT findings suggestive of this condition include enlarged porta hepatis lymph nodes with low density.
• Characteristic enhancement patterns, specifically immediate postcontrast peripheral rim enhancement, are key indicators.

Findings:

• The study highlights the diagnostic utility of CT in cases of suspected periportal tuberculous adenitis.
• Specific CT features, when correlated with clinical history and diagnostic tests like the purified protein derivative (PPD) test, can strongly suggest the diagnosis.
• Enlarged, low-attenuation porta hepatis lymph nodes with peripheral enhancement are indicative CT findings.

Implications:

• Early and accurate diagnosis via CT can lead to prompt initiation of anti-tuberculosis therapy, potentially improving patient outcomes.
• Recognition of these specific CT findings aids radiologists and clinicians in considering tuberculosis in the differential diagnosis of periportal lymphadenopathy.
• This understanding contributes to the broader knowledge of extrapulmonary tuberculosis manifestations and their radiological diagnosis.