Tuberculoma of the liver

Isolated hepatic tuberculosis in the caudate lobe mimicking intrahepatic carcinoma

Although tuberculosis (TB) remains a worldwide epidemic, isolated hepatic TB is an extremely rare entity and poorly described in the literature. Isolated hepatic TB may pose a diagnostic dilemma due to the non-specific clinical symptoms and imaging features. We present a case of a 54-year-old female with an isolated caseating granulomatous lesion at the caudate lobe of liver involving the pancreatic head.

Diagnosis and treatment of hepatic tuberculosis: report of five cases and review of literature

Hepatic tuberculosis is uncommon, lack of specific clinical manifestations and imaging features, so it can easily be misdiagnosed in clinical. Herein, we discuss variety of its forms and summarize the diagnosis and treatment of hepatic tuberculosis in this paper. Five cases of hepatic tuberculosis are described. The diagnosis, treatment and outcome of the patients are discussed. Image examination associated with image-guided fine needle aspiration biopsy is the best diagnostic method. In our center, three patients underwent needle biopsy and confirmed hepatic tuberculosis. In addition, two patients preoperative misdiagnosed as cholangiocarcinoma were confirmed hepatic tuberculosis by postoperative pathology. Three patients underwent surgical procedures along with anti-tubercular drug therapy, two patients received only anti-tubercular drug therapy. The renal post-transplantation patient with hepatic tuberculosis eventually died of multiple organ failure (MODS). The other four patients were followed for 48~120 months, yielding no recurrence of hepatic tuberculosis. In conclusion, hepatic tuberculosis usually associated with atypical clinical manifestations. Image examination associated with image-guided fine needle aspiration biopsy is the best diagnostic method. Anti-TB treatment is effective in most of cases. However, if there are indications for surgery or difficult to diagnose, surgical procedures along with anti-tubercular drug therapy could be adopted.