Ann Surg Treat Res.  2015 Aug;89(2):98-101. 10.4174/astr.2015.89.2.98.

Primary hepatic tuberculosis mimicking intrahepatic cholangiocarcinoma: report of two cases

• Park JI

• KMID: 2166978
• DOI: http://doi.org/10.4174/astr.2015.89.2.98

Abstract

Hepatic tuberculosis (TB) is usually associated with pulmonary or miliary TB, but primary hepatic TB is very uncommon even in countries with high prevalence of TB. The clinical manifestation of primary hepatic TB is atypical and imaging modalities are unhelpful for differential diagnosis of the liver mass. Image-guided needle biopsy is the best diagnostic method for primary hepatic TB. In the cases presented here, we did not perform liver biopsy because we believed the liver masses were cholangiocarcinoma, but primary hepatic TB was ultimately confirmed by postoperative pathology. Here we report two cases of patients who were diagnosed with primary hepatic TB mimicking mass-forming intrahepatic cholangiocarcinoma.

Keyword

Tuberculosis; Hepatectomy; Cholangiocarcinoma

MeSH Terms

Biopsy
Biopsy, Needle
Cholangiocarcinoma*
Diagnosis, Differential
Hepatectomy
Humans
Liver
Pathology
Prevalence
Tuberculosis
Tuberculosis, Hepatic*
Cholangiocarcinoma

Figure

• 

  Fig. 1 MRI shows relatively well defined mass (3.0 cm × 2.7 cm) on arterial phase, peripheral rim like enhancement with mainly nonenhancing lesion.

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  Fig. 2 The presence of centrally necrotic caseating granuloma (H&E, ×40) in the liver parenchyma.

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  Fig. 3 CT shows a large lobulated mass (7.0 cm × 3.5 cm) in segment 4 with mild heterogenous enhancement and focal peripheral intrahepatic duct dilatation.

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  Fig. 4 The presence of centrally necrotic caseating granuloma (H&E, ×40) in normal liver parenchyma.

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