Misidentification of hepatic tuberculosis as cholangiocarcinoma: A case report

Li, Wei; Tang, Yunlian; Huang, Xiangyu

doi:10.12998/wjcc.v9.i31.9662

Cited by 2 publications

(3 citation statements)

References 26 publications

(32 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These indicators lack characteristic clinical symptoms and specific imaging manifestations, which can easily lead to a missed or misdiagnosis. 5 A retrospective study by Longxin et al found a misdiagnosis rate of up to 91% for HTB. 6 Several clinical studies have found that HTB can easily be misdiagnosed as liver cancer, cholangiocarcinoma, or other malignant diseases.…”

Section: Introductionmentioning

confidence: 99%

“…6 Several clinical studies have found that HTB can easily be misdiagnosed as liver cancer, cholangiocarcinoma, or other malignant diseases. 5 , 7 – 8 …”

Section: Introductionmentioning

confidence: 99%

“…6 Several clinical studies have found that HTB can easily be misdiagnosed as liver cancer, cholangiocarcinoma, or other malignant diseases. 5,[7][8] The diagnosis of HTB is challenging, even in areas where TB is endemic, due to the non-specificity and diversity of its clinical symptoms. Statistically, HTB accounts for 1.5%-4.2% of digestive system diseases manifested by fever and approximately 2.7% of active TB autopsies.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Clinical Manifestations, Imaging Features, and Treatment Follow-Up of 29 Cases With Hepatic Tuberculosis

Saiduo¹,

Wei²,

Jichan³

et al. 2022

Mediterr J Hematol Infect Dis

View full text Add to dashboard Cite

To understand the clinical and imaging manifestations and the treatment and follow-up of hepatic tuberculosis (HTB), we retrospectively analyzed the clinical and imaging data of 29 patients with HTB who had been diagnosed clinically or by biopsy, and the clinical and imaging data had been summarised. Patient characteristics were followed up after anti-TB drug treatment. The median age of the 29 patients with HTB was 37 years, and most were male (58.6%). The patient's symptoms included fever (48.2%), respiratory symptoms (27.5%), abdominal pain (24.1%), and abdominal distension (10.3%). Elevated erythrocyte sedimentation rate (79.3%), elevated serum C-reactive protein (75.8%) and hypoalbuminemia (62.0%) were common features. Three patients were serologically positive for acquired human immunodeficiency syndrome, and two were serologically positive for hepatitis B surface antigen with normal tumor markers. The 29 patients with HTB included 17 with serous HTB, 9 with parenchymal HTB (8 with parenchymal nodular HTB and 1 with parenchymal miliary HTB), 1 with intrahepatic abscess type HTB, and 2 with hilar HTB. Approximately 86% of the patients also had pulmonary TB. Most of the serous HTB patients also had tuberculous peritonitis. Enhanced computerized tomography scans of the serous and parenchymal HTB cases showed the progressive development of lesions. Abnormal blood perfusion was observed in the hepatic artery, and the clearest evidence of TB was observed in the hepatic portal vein. Magnetic resonance imaging indicated that the lesions returned a high signal in the diffusion-weighted imaging sequence. However, the lesions' apparent diffusion coefficient values reflected high signals. The Xpert MTB/RIF test detected Mycobacterium TB complex in the liver biopsy fluid from 10 patients. Regarding histopathology, one patient showed granulomatous inflammation, and one patient's acid-fast bacillus (AFB) stain was positive. The treatment of two patients was stopped due to their adverse reactions to the drugs and the risk of creating drug-resistant TB. The remaining patients received anti-TB treatment, but one subsequently died, and two were unavailable for follow-up. The clinical symptoms of HTB are difficult to detect, and it has diverse manifestations by imaging, with no obvious specificity in terms of pathological results. Therefore, follow-up of liver lesions for checking anti-TB therapy is another method for diagnosing HTB. In addition, early active anti-TB treatment can achieve good curative results. Keywords: hepatic tuberculosis; CT; clinical features; X-PERT; imaging diagnosis

show abstract

Section: Introductionmentioning

confidence: 99%

“…6 Several clinical studies have found that HTB can easily be misdiagnosed as liver cancer, cholangiocarcinoma, or other malignant diseases. 5 , 7 – 8 …”

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Clinical Manifestations, Imaging Features, and Treatment Follow-Up of 29 Cases With Hepatic Tuberculosis

Saiduo¹,

Wei²,

Jichan³

et al. 2022

Mediterr J Hematol Infect Dis

View full text Add to dashboard Cite

show abstract

Characterization of pathological features and immune microenvironment in hepatic tuberculosis and pulmonary tuberculosis

Niu,

Wu,

Pan

et al. 2024

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

Hepatic tuberculosis (HTB) is rare extrapulmonary tuberculosis that is clinically similar to liver malignancy, making it difficult for correct diagnoses. Pathology is the gold standard for tuberculosis diagnosis. However, there are few reports on the pathological features of HTB. A total of 32 HTB cases were considered and the differences in pathological features and drug resistance were analyzed and compared with those for pulmonary tuberculosis (PTB). Enhanced CT scans showed ring-shaped delayed enhancement during the arterial, venous, and delayed phases. Most HTB cases were single lesions, with the highest incidence in the right lobe, and the average lesion volume was smaller than that of PTB. The frequency of granuloma in pathological changes, the overall share of the lesion area in the HTB group, and the number of foxp3+ cells were significantly higher than in the PTB group. However, no statistically significant differences were observed between the two groups’ other pathological features and immune cell numbers. The immune microenvironment of the normal tissues surrounding the lesion was further analyzed. The findings showed that the number of macrophages and foxp3+ cells in the HTB group was significantly higher than in the PTB group. No significant difference in drug resistance was detected between the HTB and PTB groups. In conclusion, there are substantial differences in the characterization of pathological feature and immune microenvironment between HTB and PTB. The frequency of granuloma and subsequent overall share of the lesion area was significantly higher in HTB compared to PTB.

show abstract

Misidentification of hepatic tuberculosis as cholangiocarcinoma: A case report

Cited by 2 publications

References 26 publications

Clinical Manifestations, Imaging Features, and Treatment Follow-Up of 29 Cases With Hepatic Tuberculosis

Clinical Manifestations, Imaging Features, and Treatment Follow-Up of 29 Cases With Hepatic Tuberculosis

Characterization of pathological features and immune microenvironment in hepatic tuberculosis and pulmonary tuberculosis

Contact Info

Product

Resources

About