Clinical Characteristics of Rare Extrapulmonary Hepatic Tuberculosis
10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2025.0517
- VernacularTitle:肺外罕见肝结核的临床特征分析
- Author:
Xingyun HU
1
;
Xiaoyan JIN
1
;
Pan YANG
1
;
Jinglan FU
1
Author Information
1. 中山大学孙逸仙纪念医院全科医学科,广东 广州 510120
- Publication Type:Journal Article
- Keywords:
hepatic tuberculosis;
clinical features;
histopathological diagnosis;
early identification;
retrospective analysis
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2025;46(5):872-880
- CountryChina
- Language:Chinese
-
Abstract:
[Objective]Hepatic tuberculosis(HTB),an exceptionally rare and clinically heterogeneous form of extra-pulmonary tuberculosis,is frequently misdiagnosed as hepatocellular carcinoma,lymphoma,or pyogenic liver abscess,this diagnostic challenge contributing to persistently high rates of missed and incorrect diagnoses.This study aims to sys-tematically analyze clinical profiles of HTB patients to provide evidence-based guidance for early identification,accurate diagnosis,and timely intervention.[Methods]We conducted a retrospective analysis of all HTB cases confirmed at Sun Yat-sen Memorial Hospital between January 2012 and December 2023.Comprehensive data were collected and evaluated,including demographic characteristics,clinical presentations,laboratory findings,imaging features,and histopathological results.[Results]Ten patients(9 males,1 female;mean age 44.6±15.5 years)were enrolled totally,with prevalent symp-tom of abdominal pain or distension(8/10).Among the patients tested,purified protein derivative(PPD)was positive in 2 of 6 cases,serum tuberculosis antibody was positive in 1 of 5,and T-cell spot of tuberculosis(T-SPOT)was positive in 3 of 5.Chest imaging(n=9)revealed active miliary tuberculosis in 1 case and inactive post-tuberculous sequelae in 5 cases,while the remainder showed no abnormalities.Contrast-enhanced CT(n=6)demonstrated hypodense patchy or nodular le-sions with absent or mild heterogeneous enhancement.MRI(n=3)showed well-circumscribed oval/round hypointense lesions on T1-weighted imaging(T1WI)and mildly hyperintense ones on T2-weighted imaging(T2WI)and diffusion weighted imaging(DWI).Percutaneous or surgical liver biopsy was performed in 8/10 cases,revealing chronic granuloma-tous inflammation in all subjects and acid-fast bacilli in 2 specimens.[Conclusion]HTB lacks pathognomonic clinical or radiological features,and conventional laboratory tests exhibit low sensitivity.A high index of suspicion is warranted for pa-tients presenting with hepatic nodular lesions accompanied by fever,abdominal pain,or emaciation.Early pathogen detec-tion and histopathological confirmation via liver biopsy are critical to minimize diagnostic delays and ensure prompt initia-tion of anti-tuberculous therapy.
