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PubMedDate not supplied

Hepatic tuberculosis: comparison of miliary and local form.

The clinical and pathological features of 22 patients, 11 males and 11 females 17-70 years of age (48.0 +/- 16.0 years), with hepatic tuberculosis were reviewed. Five patients had no evidence of extrahepatic tuberculosis (local form), and 17 had the miliary form. The clinical features of the miliary and local forms were similar with pyrexia, abdominal pain, hepatomegaly and body weight loss as the main manifestations. The biochemical findings were also quite similar in reversed albumin and globulin (A/G) ratio (2.9/3.5 vs. 3.2/3.4 g/dl) and disproportionate elevation of alkaline phosphatase (ALP) in comparison with bilirubin values but lower levels of alanine aminotransferase (ALT) (40.4 +/- 51.0 vs. 170.8 +/- 209.4 U/l; p < 0.05) and ALP (208.5 +/- 138.9 vs. 389.5 +/- 271.1 U/l; p < 0.05) in the miliary form. Patients with the local form had higher albumin (3.2 +/- 0.8 vs. 2.9 +/- 0.7 g/dl), aspartate aminotransferase (AST) (160.4 +/- 221.7 vs. 65.9 +/- 69.7 U/l), and gamma glutamyl-transpeptidase (gamma GT) (217.0 +/- 144.0 vs. 136.0 +/- 92.1 U/l), although the differences were not significant. The histopathological features of the miliary form were also similar to the local form with granuloma, caseation, acid-fast bacilli, fatty change and portal fibrosis as the main findings. The local form revealed more severe signs of hepatocytic damage while the miliary form was more wasting. The results suggest that the miliary and local forms of hepatic tuberculosis had quite similar clinical presentations and pathological features. The biochemical tests suggesting hepatic tuberculosis were reversed A/G ratio and disproportionate elevation of ALP.

Adolescent↗
PubMed1995

Nodular form of local hepatic tuberculosis: case report.

The nodular form of hepatic tuberculosis (TB) is a very uncommon disease characterized by coalescing tubercles to form tumour-like tuberculomas or abscesses without evidence of extrahepatic tuberculosis. Since 1950, 23 cases of isolated nodular TB in the liver have been reported in the world literature. In 19 of these cases laparotomy was performed and the correct diagnosis was obtained only on histologic examination. We report one additional case of multiple tuberculous abscesses which were initially diagnosed as hepatic abscesses and at intraoperative evaluation were thought to be a liver tumour. The diagnosis was made by histological examination with identification of acid-fast bacili.

Diagnosis, Differential↗
PubMed1976

[Angiographic findings in primary miliary hepatic tuberculosis (author's transl)].

The authors describe the hepatic angiographic findings in two patients with primary miliary hepatic tuberculosis. The main angiographic features are abnormalities of the distal arterioles, with small, nodular and irregular formations. The hepatic and portal veins are normal. To our knowledge, it is the first report of angiographic abnormalities in miliary tuberculosis of the liver. The diagnostic and pronostic interest of these findings are discussed.

Adult↗
PubMed1985

[Pseudotumoral form of hepatic tuberculosis. Apropos of a case report].

Concerning one case of autonomous hepatic tuberculosis in a pseudo-tumoral aspect, the difficulties of making the diagnosis are brought to light. Liver biopsy is the best examination to clarify things, either performed under ultrasonic control or during surgery. This biopsy permits pathologic examination and culture of a liver fragment in Lowenstein medium. But in fact, only isolation of the tubercle bacillus at the liver level confirms presence of tuberculosis.

Aged↗
PubMed1991

[Pseudotumor form of hepatic tuberculosis. Apropos of a case].

The authors report about one new case of hepatic tuberculosis in a pseudotumoral form, and emphasize the diagnostic difficulties even in a country where tuberculosis is endemic. Hepatic puncture, either with sonographic monitoring or during laparotomy, is the paraclinical examination of choice. The histological study supports the diagnosis. The medical treatment is that of any form of tuberculosis. The surgical treatment is most often indicated when a diagnosis of liver tumor is assumed.

Diagnosis, Differential↗
PubMed2005

Macronodular hepatic tuberculosis associated with portal vein thrombosis and portal hypertension.

Tuberculosis (TB) of the liver is usually associated with miliary spread. Macronodular TB of the liver is rare. A case of macronodular TB of the liver in a 31-year-old woman causing portal vein thrombosis and portal hypertension is presented. Ultrasound and CT appearances are described. There was coexistent ileo-caecal TB with extensive mesenteric and retroperitoneal lymphadenopathy. Macronodular TB should be considered in the differential diagnosis when a patient presents with multiple calcified masses in the liver with portal vein thrombosis and portal hypertension.

Adult↗
PubMed1999

[Hepatic tuberculosis of the pseudotumoral form].

The authors report a case of a 30 years old immunocompetent woman with liver tuberculosis with an unusual pseudotumoral presentation and secondary occurrence of abcedation with cutaneous fistulization. The diagnosis was based on the bacteriological positivity for acido-alcoolo resistant bacillus in pus of the abscess obtained by ponction guided by ultrasonographic examination. The authors emphasize in the differential diagnosis with the other causes of liver abscess (amibiasis and pyogenic microorganisms) and liver carcinoma. They also note the importance of the function guided by ultrasonographic examination permitting histologic and bacte+ériologic study in the diagnosis of this unusual presentation of liver tuberculosis. The patient was treated by antibacillary antibiotics and evacuation function. The prognostic was good with 6 months of follow-up.

Adult↗
PubMedDate not supplied

Hepatic tuberculosis mimicking carcinoma gall bladder.

We report a 50-year-old man with tuberculosis of the liver with calculous cholecystitis. The diagnosis was made when the patient underwent cholecystectomy. He responded to antitubercular therapy.

Antitubercular Agents↗