rss
J Clin Pathol 2003;56:835-839 doi:10.1136/jcp.56.11.835
  • Original article

The nodular form of hepatic tuberculosis: a review with five additional new cases

  1. W-T Huang1,
  2. C-C Wang2,
  3. W-j Chen1,
  4. Y-F Cheng3,
  5. H-L Eng1
  1. 1Department of Pathology, Chang Gung University and Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
  2. 2Department of Surgery, Chang Gung University and Memorial Hospital
  3. 3Department of Radiology, Chang Gung University and Memorial Hospital
  1. Correspondence to:
 Dr H-L Eng
 Department of Pathology, Kaohsiung Medical Center, Chang Gung Memorial Hospital, 123, Ta-pei Road, Niao-Sung Hsiang, Kaohsiung County, Taiwan; eng6166ms8.hinet.net
  • Accepted 28 May 2003

Abstract

Background: Tuberculosis presenting as an isolated liver tumour, without active pulmonary or miliary tuberculosis, or other clinical evidence of tuberculosis, is distinctly rare. A greater awareness of this rare clinical entity may prevent needless surgical intervention.

Aims: To help characterise this distinctly rare presentation of tuberculosis, five new cases are presented, together with a review of the world literature. The clinical, laboratory, radiological, and pathological features of these patients are described.

Methods: Polymerase chain reaction (PCR) assay of the liver tissue was carried out in all cases to confirm an aetiological diagnosis of Mycobacterium tuberculosis infection.

Results: All five patients (44–71 years old; two women, three men) underwent surgery, and had a preoperative diagnosis of malignant hepatic neoplasm and a postoperative histological diagnosis of chronic granulomatous inflammation, suggestive of tuberculosis. None of them had a known previous history of tuberculosis. All of them were positive for M tuberculosis by PCR analysis of the liver tissue.

Conclusions: This report illustrates the difficulty in reaching a correct preoperative diagnosis. It is usually unsuspected and confused with primary or metastatic carcinoma of the liver, especially when it coexists with other malignancies. A high index of suspicion is required for diagnosis, which can be made only by histological and bacteriological studies, and PCR analysis.

Footnotes

    This Article

    1. Abstract
    2. Full text
    3. PDF

    Responses

    1. Submit a response
    2. No responses published

    Register for free content

    The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

    Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.