A CASE OF LIVER TUBERCULOSIS REQUIRING DIFFERENTIATION WITH LIVER METASTASIS OF CANCER

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  • KOBAYASHI Kanako
    Department of Pulmonary Medicine, National Hospital Organization Matsue National Hospital
  • YANO Shuichi
    Department of Pulmonary Medicine, National Hospital Organization Matsue National Hospital
  • IKEDA Toshikazu
    Department of Pulmonary Medicine, National Hospital Organization Matsue National Hospital
  • TOKUDA Yoshiyuki
    Department of Pulmonary Medicine, National Hospital Organization Matsue National Hospital
  • TOUGE Hirokazu
    Department of Pulmonary Medicine, National Hospital Organization Matsue National Hospital
  • ISHIKAWA Shigenori
    Department of Pulmonary Medicine, National Hospital Organization Matsue National Hospital
  • TAKEYAMA Hiroyasu
    Department of Pulmonary Medicine, National Hospital Organization Matsue National Hospital

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Other Title
  • 肝転移と鑑別を要した肝結核の１例
  • カン テンイ ト カンベツ オ ヨウシタ カンケッカク ノ 1レイ

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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.

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