A Case of Solitary Hepatic Tuberculoma

Tetsu Shiraishi, Nobuhiro Kawamura, Toru Yamaoka, Ken Kondo, Tsuyoshi Sato

Departnent of Surgery, Toyohashi National Hospital

Local hepatic tuberculosis, of nodular form, is extremely rare. A 48-year-old man presented with fever and right hypochondralgia. Based on the results of laboratory studies, ultrasonography, computed tomography and angiography, we suspected a malignant tumor of the right hepatic lobe. To make a definitive diagnosis, percutaneous liver needle biopsy was performed. An epithelioid granuloma surrounding caseous necrosis, compatible with tuberculoma, was revealed. After 6 months of antituberculous therapy, the hepatic lesion had disappeared completely on the imaging studies. This diagnosis is quite often missed as tuberculomas mimic hepatic malignant tumors. In most of cases, the definitive diagnosis can ultimately be comfirmed by histological and bacteriological study of the resected specimen, and in only a few cases in the literature, has the correct diagnosis been made by histological examination of a percutaneous liver needle biopsy.

Key words
solitary hepatic tuberculoma, percutaneous liver needle biopsy, antituberculous therapy

Reprint requests
Tetsu Shiraishi Department of Surgery, Toyohashi National Hospital
100 Aza-nakahara, Nakano-cho, Toyohashi City, 441 JAPAN

Accepted
November 13, 1996

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