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酷似胆囊癌伴肝侵犯的原发性肝胆结核:一例报告

Primary hepaticobiliary tuberculosis mimicking gall bladder carcinoma with liver invasion: a case report.

作者信息

Haque Muhammad Manzoor Ul, Whadva Rajesh Kumar, Luck Nasir Hassan, Mubarak Muhammed

机构信息

Department of Hepatogastroentrology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan.

Department of Histopathology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan.

出版信息

Pan Afr Med J. 2019 Feb 7;32:68. doi: 10.11604/pamj.2019.32.68.10519. eCollection 2019.

Abstract

Primary hepatic tuberculosis is a rare presentation and sporadically reported in the literature, mostly from our part of the world. Sometimes the presentation can be atypical and mimics hepatic tumor and poses diagnostic challenge. We, herein, present a case of a 58-year-old man who presented to us with abdominal pain and weight loss. Raised serum alkaline phosphatase (ALP) and imaging raised a suspicion of gall bladder carcinoma with hepatic invasion. Peroperative frozen section revealed hepatic chronic granulomatous inflammation with caseous necrosis consistent with the diagnosis of hepatic tuberculosis. Surgery was postponed and he was put on antituberculous treatment. It is important to consider tuberculosis in the differential diagnosis of the space occupying lesion of liver in a patient with vague symptoms and abnormal findings on imaging.

摘要

原发性肝结核较为罕见,文献中偶有报道,大多来自我们所在的地区。有时其表现可能不典型,类似肝肿瘤,给诊断带来挑战。在此,我们报告一例58岁男性患者,因腹痛和体重减轻前来就诊。血清碱性磷酸酶(ALP)升高及影像学检查提示胆囊癌伴肝侵犯。术中冰冻切片显示肝脏慢性肉芽肿性炎症伴干酪样坏死,符合肝结核诊断。手术延期,患者接受抗结核治疗。对于症状不明确且影像学检查有异常发现的肝脏占位性病变患者,在鉴别诊断时考虑结核病很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f59/6560998/b87f585df9c2/PAMJ-32-68-g001.jpg

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