Seong Jichang, Dilshod Egamberdiev, Ravshan Abdusattorov
School of Medicine, Central Asian University, 264 Milliy, bog St, Tashkent 111221, Uzbekistan.
Department of Hepatopancreatobiliary Surgery, Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology, Farobi Street 5-7, Tashkent 100174, Uzbekistan.
Oxf Med Case Reports. 2025 May 28;2025(5):omaf030. doi: 10.1093/omcr/omaf030. eCollection 2025 May.
Hepatic tuberculosis is a rare extrapulmonary manifestation of pulmonary or miliary tuberculosis, typically seen in immunocompromised individuals. Isolated nodular hepatic tuberculosis is exceptionally uncommon in immunocompetent individuals and often mimics other hepatic lesions such as hepatocellular carcinoma. We present a 35-year-old male who developed isolated nodular hepatic tuberculosis following high-dose dexamethasone treatment for COVID-19. Imaging and fine-needle aspiration cytology suggested hepatocellular carcinoma, prompting surgical hepatic segmentectomy. Postoperative histopathological analysis confirmed the diagnosis of isolated nodular hepatic tuberculosis. This case highlights the potential risk of hepatic tuberculosis during temporary immunosuppression caused by high-dose dexamethasone treatment for COVID-19. Our case also emphasizes the importance of utilizing preoperative PCR and histopathological examination in diagnosing hepatic tuberculosis, helping to prevent unnecessary surgical interventions.
肝结核是肺结核或粟粒性结核罕见的肺外表现，通常见于免疫功能低下的个体。孤立性结节性肝结核在免疫功能正常的个体中极为罕见，且常与其他肝脏病变如肝细胞癌相似。我们报告一名35岁男性，在接受高剂量地塞米松治疗新冠肺炎后发生了孤立性结节性肝结核。影像学和细针穿刺细胞学检查提示为肝细胞癌，遂行肝段切除术。术后组织病理学分析确诊为孤立性结节性肝结核。该病例凸显了高剂量地塞米松治疗新冠肺炎导致暂时免疫抑制期间发生肝结核的潜在风险。我们的病例还强调了术前使用聚合酶链反应（PCR）和组织病理学检查对诊断肝结核的重要性，有助于避免不必要的手术干预。
