Keri Vishakh C, Jorwal Pankaj, Kodan Parul, Biswas Ashutosh
Department of Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India.
Department of Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
BMJ Case Rep. 2020 Feb 19;13(2):e233303. doi: 10.1136/bcr-2019-233303.
Hepatosplenic space occupying lesions are usually labelled as metastasis. This case highlights the importance of thinking beyond malignancy and the importance of adopting a systematic approach when dealing with such lesions that have a plethora of close differentials. Hepatosplenic tuberculosis is a rare form of extra pulmonary tuberculosis. Timely diagnosis and treatment turned the table from a probable dismal prognosis to a completely curable cause. We report an unusual case, which was provisionally labelled as malignancy, due to isolated liver and spleen involvement but on evaluation turned out to be tuberculosis. The patient got cured with 6 months of anti-tubercular therapy. The report also brings to light the possible use of molecular methods like cartridge-based nucleic acid amplification test in diagnosing hepatobiliary tuberculosis, the literature about which is very scarce and limited.
肝脾占位性病变通常被标记为转移瘤。该病例凸显了跳出恶性肿瘤思维的重要性，以及在处理有众多相近鉴别诊断的此类病变时采用系统方法的重要性。肝脾结核是肺外结核的一种罕见形式。及时的诊断和治疗使病情从可能的预后不良转变为完全可治愈。我们报告一例不寻常的病例，该病例最初因孤立的肝脏和脾脏受累而被初步诊断为恶性肿瘤，但经评估发现是结核病。患者接受6个月的抗结核治疗后痊愈。该报告还揭示了基于盒式核酸扩增试验等分子方法在诊断肝胆结核方面的可能应用，关于这方面的文献非常稀少且有限。
