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免疫功能正常患者的肝结核意外诊断

The Unexpected Diagnosis of Hepatic Tuberculosis in an Immunocompetent Patient.

作者信息

Garmpis Nikolaos, Damaskos Christos, Garmpi Anna, Liakea Aliki, Mantas Dimitrios

机构信息

Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

First Propedeutic Internal Medicine Department, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

出版信息

Case Rep Surg. 2020 Oct 6;2020:7915084. doi: 10.1155/2020/7915084. eCollection 2020.

Abstract

BACKGROUND/AIM: Tuberculosis (TB) is a chronic infectious disease which affects millions. The most affected system is the respiratory. Thus, hepatic TB (HTB) without involvement of other organs is not common. Its clinical manifestations are not specific, and both imaging and histopathological findings are necessary for the diagnosis. The differential diagnosis includes primary and metastatic liver malignancies. Our aim is to describe the rare entity of HTB via a case presentation. . We report a case of a 50-year-old female with abdominal pain, weight loss, fever, and anorexia. All imaging methods described a liver lesion. She underwent right lobe hepatectomy, and the histological evaluation demonstrated granuloma with central caseous necrosis.

RESULTS

Seven months postoperatively, the patient remains fit and healthy.

CONCLUSION

HTB is a rare entity with no specific symptoms, signs, and no laboratory nor imaging findings. It can be managed effectively if diagnosed in time or lead to death if left untreated.

摘要

背景/目的:结核病(TB)是一种影响数百万人的慢性传染病。受影响最严重的系统是呼吸系统。因此,不涉及其他器官的肝结核(HTB)并不常见。其临床表现不具有特异性,诊断需要影像学和组织病理学检查结果。鉴别诊断包括原发性和转移性肝脏恶性肿瘤。我们的目的是通过病例报告描述HTB这种罕见疾病。我们报告一例50岁女性病例,该患者有腹痛、体重减轻、发热和厌食症状。所有影像学检查均发现肝脏有病变。她接受了右叶肝切除术,组织学评估显示有中央干酪样坏死的肉芽肿。

结果

术后七个月,患者保持健康。

结论

HTB是一种罕见疾病,没有特异性症状、体征,也没有实验室及影像学检查结果。如果及时诊断,可有效治疗,否则若不治疗会导致死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b849/7557907/7fabb2bf047a/CRIS2020-7915084.001.jpg

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