Abstract
Tuberculosis (TB) usually involves the liver in the form of miliary TB as part of generalized miliary TB. Localized liver TB in the form of tumor or abscess is very rare. The aim of this study is to review and analyse the clinical presentation of hepatic TB. Eleven pathologically-proven hepatic TB cases were reviewed at Kaohsiung Veterans General Hospital between the years of 1990 and 1999. Definitive diagnosis was established with the presence of either a caseous necrosis, granuloma, or acid-fast bacillus. The mean age of the patients was 65 years old. Fever was the most common symptom. Elevated alkaline-phosphatase and hypoalbuminemia were the most frequent laboratory findings. Of the 11 cases, eight were found to have diffuse infiltrative lesions of the liver (73%), while three (27%) had lesions that mimicked liver tumor or abscess. Four patients received at least six months of anti-TB medications, and of these, three resulted in complete recoveries. Three patients died of other diseases, and four patients were lost to follow-up. The most common presentation of hepatic TB is in miliary form. Liver biopsy should be carried out in every suspected case to obtain a definitive diagnosis, and prompt anti-TB treatment can be very effective in compliant patients.
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