[Case of liver tuberculosis requiring differentiation from liver metastasis of cancer].
A 79-year-old woman was admitted to our hospital because of general fatigue. Chest radiograph and computed tomograph showed bronchiectasis and centrilobular nodules in the right middle lobe and lingula, which had not changed from previous examination. Intrahepatic nodular lesions and swelling of the left cervical lymph nodes, supraclavicular lymph node, abdominal paraaortic lymph nodes and inguinal lymph nodes was observed. Biopsy specimen of the liver lesion demonstrated epithelioid cell granulomas. Biopsy of the right inguinal lymph node demonstrated epithelioid cell granulomas with caseous necrosis and culture of the specimen showed Mycobacterium tuberculosis. The patient was diagnosed as having liver tuberculosis and multiple tuberculous lymphadenitis. Antituberculous treatment with isoniazid, rifampicin, ethambutol and pyrazinamide were started and continued for 6 months. All lesions improved after treatment. This was a rare case of liver tuberculosis that was difficult to distinguish from liver metastasis of cancer.
Kobayashi
Kanako
K
Department of Pulmonary Medicine, National Hospital Organization Matsue National Hospital, 5-8-31, Agenogi, Matsue-shi, Shimane 690-8556, Japan. koba@matsue.hosp.go.jp
Yano
Shuichi
S
Ikeda
Toshikazu
T
Tokuda
Yoshiyuki
Y
Touge
Hirokazu
H
Ishikawa
Shigenori
S
Takeyama
Hiroyasu
H
D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004977:Ethambutol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000556:secondary; D008207:Lymphatic Metastasis; D011718:Pyrazinamide / Q000627:therapeutic use; D012293:Rifampin / Q000627:therapeutic use; D016896:Treatment Outcome; D014386:Tuberculosis, Hepatic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D014388:Tuberculosis, Lymph Node / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy
D000995:Antitubercular Agents; D011718:Pyrazinamide; D004977:Ethambutol; D007538:Isoniazid; D012293:Rifampin