Tuberc Respir Dis.  2012 Jan;72(1):88-92.

A Case of Multi-Organ Macronodular Tuberculosis

• Lim KR
• Kang MH
• Kim TS
• Moon KW
• Ryu DR
• Lee HY
• Han SS

Abstract

A 37 year old female presented with epigastric pain and weight loss over a period of 3 months. Her abdominal CT finding showed a 4.5 cm size hepatic mass and 4.3 cm size pancreatic head mass with multiple macronodules in the liver. At the same time, her chest CT revealed a 5 cm size necrotic mass in the left lower lobe of the lung with multiple bilateral pulmonary nodules. We diagnosed these lesions as tuberculosis through multiple biopsies. She was treated with anti-tuberculous medication. After taking the medications, her symptoms were improved. Twelve months later, imaging studies indicated an improvement in the patient's health. Here we report a case report of multi-organ macronodular tuberculosis in lung, liver and pancreas.

Keyword

Tuberculoma; Tuberculosis, Hepatic; Multiple Pulmonary Nodules; Pancreas

MeSH Terms

Biopsy
Female
Head
Humans
Liver
Lung
Multiple Pulmonary Nodules
Pancreas
Thorax
Tuberculoma
Tuberculosis
Tuberculosis, Hepatic
Weight Loss

Figure

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  Figure 1 Simple chest PA showed an approximately 5 cm size consolidation in the retrocardiac area (A, black arrow heads) and nearly complete resolution after treatment (B).

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  Figure 2 (A) Abdominal contrast enhanced CT images showed an approximately 4.5 cm size mass (black arrow) in the central liver. (B) Multiple variable size low density masses (black arrow heads) in the liver and a 4.5 cm size mass in the head of the pancreas (white arrow). CT: computed tomography.

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  Figure 3 Chest CT images revealed a 5 cm size irregular necrotic mass (white arrow) in LLL (A) and multiple nodules (black arrow heads) in both lungs (B~D). CT: computed tomography; LLL: left lower lobe.

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  Figure 4 Microscopic findings of the lesion. (A) Needle biopsy of the lung showed chronic granulomatous inflammation without necrosis (H&E stain, ×100). (B) Needle biopsy of the liver showed chronic granulomatous inflammation with caseous necrosis (arrow) (H&E stain, ×200).

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  Figure 5 A follow up chest CT revealed decreased irregular necrotic mass (white arrows) in the lung (A), liver (B), and pancreas head (C). CT: computed tomography.

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