Faculty of Hepato-Pancreato-Biliary Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, China.
Department of Pathology, The Eighth Medical Center of Chinese PLA General Hospital, Beijing, China.
Front Cell Infect Microbiol. 2024 Sep 30;14:1418225. doi: 10.3389/fcimb.2024.1418225. eCollection 2024.
Hepatic tuberculosis (HTB) is rare extrapulmonary tuberculosis that is clinically similar to liver malignancy, making it difficult for correct diagnoses. Pathology is the gold standard for tuberculosis diagnosis. However, there are few reports on the pathological features of HTB. A total of 32 HTB cases were considered and the differences in pathological features and drug resistance were analyzed and compared with those for pulmonary tuberculosis (PTB). Enhanced CT scans showed ring-shaped delayed enhancement during the arterial, venous, and delayed phases. Most HTB cases were single lesions, with the highest incidence in the right lobe, and the average lesion volume was smaller than that of PTB. The frequency of granuloma in pathological changes, the overall share of the lesion area in the HTB group, and the number of foxp3 cells were significantly higher than in the PTB group. However, no statistically significant differences were observed between the two groups' other pathological features and immune cell numbers. The immune microenvironment of the normal tissues surrounding the lesion was further analyzed. The findings showed that the number of macrophages and foxp3 cells in the HTB group was significantly higher than in the PTB group. No significant difference in drug resistance was detected between the HTB and PTB groups. In conclusion, there are substantial differences in the characterization of pathological feature and immune microenvironment between HTB and PTB. The frequency of granuloma and subsequent overall share of the lesion area was significantly higher in HTB compared to PTB.
肝结核(Hepatic tuberculosis,HTB)是罕见的肺外结核,其临床表现与肝脏恶性肿瘤相似,难以做出正确诊断。病理学是诊断结核的金标准。然而,关于 HTB 的病理学特征的报道较少。本研究共纳入 32 例 HTB 病例,分析并比较了其与肺结核(pulmonary tuberculosis,PTB)的病理学特征和耐药性差异。增强 CT 扫描显示动脉期、静脉期和延迟期呈环形延迟强化。大多数 HTB 病例为单发病变,右叶发病率最高,病变体积小于 PTB。病理学变化中肉芽肿的频率、HTB 组病变面积的总体比例以及 foxp3 细胞的数量明显高于 PTB 组。然而,两组的其他病理学特征和免疫细胞数量之间没有统计学差异。进一步分析了病变周围正常组织的免疫微环境。结果表明,HTB 组巨噬细胞和 foxp3 细胞的数量明显高于 PTB 组。HTB 和 PTB 组之间未检测到耐药性的显著差异。总之,HTB 和 PTB 在病理学特征和免疫微环境方面存在显著差异。与 PTB 相比,HTB 中肉芽肿的频率和随后的病变面积总体比例明显更高。