Arora Raman, Sharma Alok, Bhowate Prashant, Bansal Vijender Kumar, Guleria Sandeep, Dinda Amit Kumar
Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
Indian J Pathol Microbiol. 2008 Jul-Sep;51(3):382-5. doi: 10.4103/0377-4929.42517.
Tubercular involvement of liver is rare and usually occurs in association with pulmonary or miliary tuberculosis, as diffuse involvement without recognizable pulmonary tuberculosis or rarely in a localized form, which presents as a tuberculoma or tubercular abscess. We report the case of a 22-year-old boy presenting with features of obstructive jaundice and a clinico-radiological picture highly suggestive of a perihilar cholangiocarcinoma (Klatskin tumor), but found to have tubercular involvement of porta hepatis. We review the literature on this unusual presentation, highlight the considerable diagnostic challenge such cases can pose, and also emphasize the need to consider tuberculosis in differential diagnosis of lesions involving the porta hepatis, particularly in areas endemic for the disease.
肝脏结核累及较为罕见，通常与肺结核或粟粒性结核同时发生，表现为无明显肺结核的弥漫性累及，或罕见的局限性形式，即表现为结核瘤或结核脓肿。我们报告了一例22岁男孩的病例，该男孩表现为梗阻性黄疸的特征，临床放射学表现高度提示肝门部胆管癌（克氏瘤），但发现肝门部存在结核累及。我们回顾了关于这种不寻常表现的文献，强调了此类病例可能带来的巨大诊断挑战，并强调在鉴别诊断累及肝门部的病变时，尤其是在该病的流行地区，需要考虑结核病。
