A case of solitary tuberculosis of the liver

Abstract

The liver involvement by tuberculosis in the macronodular form is quite rare and one must know their clinical features and actual imaging to have precise diagnosis. We present a case of the solitary hepatic tuberculosis, of which angiographic findings originally suggested hepatocellular carcinoma (HCC) given Lipiodol Ultra Fluid (LUF). On angiogram the tuberculoma showed marked hypervascularity in a capillary phase. Histological examination of the biopsy specimen disclosed granulomas with central coagulation necrosis. A good clinical response was achieved with a course of Isoniazid and Rifampicin. Angiographic findings of one year later showed hypovascularity. Meanwhile LUF remained long in the tuberculoma marginally, presenting nodular opacities on lipiodolized CT. This finding was different from that of HCC. We also discussed those clinical actual imaging and pathological findings.