title: Isolated tuberculous liver abscess invading the abdominal wall: report of a case.
abstract: Isolated tuberculous liver parenchymal and subcapsular abscesses are unusual,^but an abdominal wall abscess secondary to a tubercular liver abscess is extremely rare. To our knowledge, there is only one reported case of an abdominal wall abscess occurring secondary to a subcapsular liver abscess. We report the first documented case of direct invasion of the abdominal wall from an isolated tuberculous liver parenchymal abscess, diagnosed by imaging, surgical, and pathological findings. Although ultrasonography and computed tomography showed nonspecific hypoechoic and hypodense findings with peripheral contrast enhancement, T2-weighted magnetic resonance imaging (MRI) revealed a heterogeneous mass with characteristic hypointensity, suggesting the presence of free radicals produced by macrophages during active phagocytosis in tuberculosis. Although our case is extremely unusual, when hypointensity on T2-weighted MRI is seen, the possibility of tuberculosis should be considered and the results of polymerase chain reaction, culture, and histopathological diagnosis must be taken into account to avoid needless invasive surgery.
authors.affiliation: Department of Radiology, Nihon University School of Medicine, 30-1 Oyaguchi kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Abe
authors.forename: Takuya
authors.initials: T
authors.lastname: Aizawa
authors.forename: Toshiya
authors.initials: T
authors.lastname: Maebayashi
authors.forename: Hisashi
authors.initials: H
authors.lastname: Nakayama
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sugitani
authors.forename: Masakuni
authors.initials: M
authors.lastname: Sakaguchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Shizukuishi
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yano
authors.forename: Tadatoshi
authors.initials: T
authors.lastname: Takayama
authors.forename: Motoichiro
authors.initials: M
authors.lastname: Takahashi
mesh_terms: D018784:Abdominal Abscess / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D034861:Abdominal Wall; D006801:Humans; D008100:Liver Abscess / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D014386:Tuberculosis, Hepatic / Q000150:complications* / Q000175:diagnosis / Q000473:pathology