Isolated hepatic tuberculosis presenting as hydatid cyst

Clin J Gastroenterol. 2020 Jun;13(3):408-412. doi: 10.1007/s12328-019-01071-w. Epub 2019 Nov 22.

Abstract

Primary hepatic tuberculosis is a rare manifestation of extra-pulmonary tuberculosis even in highly endemic countries. The incidence of hepatic tuberculosis has increased in the recent years due to high prevalence of HIV/AIDS. Radiological imaging is an important tool for making the diagnosis, but often the imaging findings are non-specific and may mimic other benign or malignant hepatic diseases. We report a case of 54-year-old woman who was detected to have hepatic mass on radiological imaging which was misdiagnosed as hydatid cyst. Intraoperatively, the characteristic features of hydatid cyst were absent. A partial resection of this cystic mass was performed. Histopathological examination of the resected specimen revealed granulomatous inflammation consisting of histiocytes and Langhans-type giant cells surrounded by lymphocytes suggestive of hepatic tuberculosis. The patient was administered antitubercular therapy for 1 year. Repeat imaging on follow up showed disappearance of the hepatic lesion.

Keywords: Hydatid cyst; Liver; Primary hepatic tuberculosis; Tuberculoma.

Publication types

  • Case Reports

MeSH terms

  • Antitubercular Agents / therapeutic use
  • Combined Modality Therapy
  • Diagnostic Errors
  • Echinococcosis, Hepatic / diagnosis*
  • Echinococcosis, Hepatic / diagnostic imaging
  • Female
  • Hepatectomy
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Radiography
  • Tomography, X-Ray Computed
  • Tuberculosis, Hepatic / diagnosis*
  • Tuberculosis, Hepatic / diagnostic imaging
  • Tuberculosis, Hepatic / therapy

Substances

  • Antitubercular Agents