Department of Biliary and Minimally Invasive Surgery, China Medical University Shengjing Hospital Shenyang, No. 36, San Hao Street, Shenyang, 110004, Liaoning, China.
BMC Infect Dis. 2019 Mar 4;19(1):217. doi: 10.1186/s12879-019-3850-5.
Hepatobiliary tuberculosis is a rare manifestation of Mycobacterium tuberculosis infection, especially in younger patients. The non-specific symptoms and signs as well as the lack of definite imaging characteristics often impedes diagnosis. Definite diagnosis of tuberculosiscan be obtained through histopathological examination; conventional anti-tuberculosis drugs and surgery are the most commonly recommended treatments.
A previously healthy 15-year-old rural adolescent male presented with a 2-month history of weight loss and fatigue. We strongly suspected a Klatskin tumor; therefore, exploratory laparotomy was performed. However, the microscopical findings revealed a granuloma consisting of epithelioid cells, caseous necrosis, and lymphocytic infiltration, indicating caseating granulomatous inflammation and yielding a final diagnosis of hepatic hilar tuberculosis.
Hepatic hilar tuberculosis is an extremely rare case; few physicians may have actually treated a case. This report therefore aims to improve the overall understanding of lymphatic tuberculosis of the hepatic hilum.
肝胆结核是结核分枝杆菌感染的一种罕见表现,尤其是在年轻患者中。非特异性症状和体征以及缺乏明确的影像学特征常常妨碍诊断。通过组织病理学检查可明确诊断结核,通常推荐使用常规抗结核药物和手术治疗。
一名既往健康的 15 岁农村青少年男性,因体重减轻和乏力就诊,病程 2 个月。我们强烈怀疑为 Klatskin 肿瘤,因此进行了剖腹探查术。然而,显微镜下的发现显示为上皮样细胞、干酪样坏死和淋巴细胞浸润的肉芽肿,提示干酪样肉芽肿性炎症,最终诊断为肝门部结核。
肝门部结核极为罕见,可能很少有医生实际治疗过此类病例。因此,本报告旨在提高对肝门部淋巴结结核的整体认识。