Kim D W, Cho H S, Lee H J, Seo J W, Kim H-J, Park D J, Chang S-H
Department of Internal Medicine, Gyeongsang National University, Jinju, Republic of Korea.
Clin Nephrol. 2009 Aug;72(2):143-6. doi: 10.5414/cnp72143.
A tuberculous liver abscess is an extremely rare condition. However, extrapulmonary tuberculosis is more common in end-stage renal disease patients. We report a 64-year-old woman on hemodialysis with liver cirrhosis. She had no evidence of pulmonary or intestinal tuberculosis on the chest radiograph, abdominal computed tomography (CT), or colonoscopy. She had fever and an enlarged right supraclavicular lymph node. A CT showed several cystic ring-enhancing nodules in the liver. Histopathologic examinations were performed on the enlarged lymph node and a cystic nodule in the liver, which revealed caseating granulomas. Systemic antituberculous therapy was started immediately. A subsequent sonographic examination of the lesion in the liver showed improvement. In end-stage renal disease patients, we should be concerned with extrapulmonary tuberculosis. The diagnosis and antituberculous therapy must be performed promptly.
肝结核脓肿是一种极为罕见的病症。然而，肺外结核在终末期肾病患者中更为常见。我们报告一例64岁接受血液透析的肝硬化女性患者。胸部X线片、腹部计算机断层扫描（CT）及结肠镜检查均未发现肺部或肠道结核迹象。她有发热症状且右锁骨上淋巴结肿大。CT显示肝脏有多个环形强化的囊性结节。对肿大的淋巴结及肝脏的一个囊性结节进行了组织病理学检查，结果显示为干酪样肉芽肿。随即开始进行全身抗结核治疗。随后对肝脏病变进行的超声检查显示病情有所改善。对于终末期肾病患者，我们应关注肺外结核。必须及时进行诊断和抗结核治疗。
