ATYPICAL LIVER LESIONS: PRIMARY HEPATIC TUBERCULOSIS

Kumail Khandwala; Muhammad Ismail Alvi; Nida Sajjad; Waseem Akhtar Mirza

ATYPICAL LIVER LESIONS: PRIMARY HEPATIC TUBERCULOSIS

Kumail Khandwala, Muhammad Ismail Alvi, Nida Sajjad, Waseem Akhtar Mirza

Abstract

Hepatic tuberculosis is seen in 50-80% of patients with disseminated tuberculosis. However, isolated hepatic tuberculosis is rarely encountered in an immunocompetent patient, even in regions with high prevalence of tuberculosis.

We report a case of a 43-year-old male who underwent triphasic computed tomography (CT) scan for an uncharacterized hypoechoic liver lesion found on ultrasound. CT scan revealed multiple ill-defined areas in segments VI and IV of the liver, which were reported as atypical liver lesions. Differentials of atypical hepatoma versus hepatic metastasis from an unknown primary were given. Subsequently, biopsy of the lesion was performed and histopathology report revealed chronic granulomatous inflammation with tuberculosis as a likely possibility. The patient was started on antituberculous therapy and responded to treatment.

This case emphasizes the diagnostic difficulties of hepatic tuberculosis and the significance of considering this differential in patients with atypical hepatic lesions. It is vital for radiologists to identify unusual presentations of tuberculosis, which is an ever-growing problem in our part of the world.

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