Isolated hepatosplenic tuberculosis.

BACKGROUND

Tuberculosis rarely involves the liver and spleen and when it does so, it is usually associated with disseminated disease.

METHOD

We report a patient with isolated tuberculosis of the liver and spleen.

RESULTS

A 50-year-old man presented with weakness and loss of weight for two months. CT scan of the abdomen showed multiple small hypodense lesions in the liver and spleen. Image-guided biopsy of liver lesion was inconclusive as it showed normal hepatocytes with interspersed lymphocytes. On laparotomy, the liver and spleen were studded with multiple small nodules. A 5-cm wedge of the liver was resected. Histopathological examination confirmed the diagnosis of tubercular hepatitis. A detailed work-up failed to identify any other focus of tuberculosis.

CONCLUSION

Although rare, tuberculosis should also be considered in the differential diagnosis for multiple nodules in the liver and spleen, along with lymphoproliferative diseases and metastatic lesions.