Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2021; 9(31): 9662-9669
Published online Nov 6, 2021. doi: 10.12998/wjcc.v9.i31.9662
Misidentification of hepatic tuberculosis as cholangiocarcinoma: A case report
Wei Li, Yan-Fen Tang, Xue-Feng Yang, Xiang-Yu Huang
Wei Li, Yan-Fen Tang, Xiang-Yu Huang, The Affiliated Nanhua Hospital, Department of Radiology, Hengyang Medical School, University of South China, Hengyang 421002, Hunan Province, China
Xue-Feng Yang, The Affiliated Nanhua Hospital, Department of Gastroenterology, Hengyang Medical School, University of South China, Hengyang 421002, Hunan Province, China
Author contributions: Li W was a major contributor in reviewing the literature and writing the manuscript; Tang YF and Huang XY prepared and collected the case data, Tang YF contributed to the manuscript revision; Yang XF made critical revisions related to important intellectual content of the manuscript; all authors read and approved the final manuscript.
Informed consent statement: The present study was approved by the Ethics Committee of the Affiliated Nanhua Hospital, Hengyang Medical College, the patient signed a written informed consent form prior to commencing the study.
Conflict-of-interest statement: The authors report no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Fen Tang, MS, Attending Doctor, The Affiliated Nanhua Hospital, Department of Radiology, Hengyang Medical School, University of South China, No. 336 Dongfeng South Road, Zhuhui District, Hengyang 421002, Hunan Province, China. 413184847@qq.com
Received: May 28, 2021
Peer-review started: June 2, 2021
First decision: June 24, 2021
Revised: June 28, 2021
Accepted: September 8, 2021
Article in press: September 8, 2021
Published online: November 6, 2021
Abstract
BACKGROUND

Hepatic tuberculosis (TB) is uncommon clinically. Because of a lack of specific signs, characteristic symptoms and clinical manifestations and because pathological samples are difficult to obtain, hepatic TB is easily missed or misdiagnosed.

CASE SUMMARY

A 62-year-old Chinese man presented with jaundice for 1 wk and no abnormal laboratory tests other than elevated bilirubin, aminotransferases and C-reactive protein. Computed tomography (CT) of the abdomen showed a mass in the left lobe of the liver and hepatic hilum with striped calcified foci. Mild enhancement was visible at the edges, along with extensive intrahepatic biliary ductal dilatation in the right lobe of the liver. In the arterial phase of both CT and magnetic resonance imaging, the main trunk and right branch of the portal artery were partially visualized. Magnetic resonance cholangiopancreatography (MRCP) indicated that the left lobe of the liver and most of the bile ducts in the hilum were not visible. Pathological examination revealed coagulative necrosis, and granulomatous nodules were seen around areas of necrosis; therefore, TB was considered.

CONCLUSION

Hepatic tuberculosis is easily misdiagnosed or missed on imaging. Percutaneous puncture biopsy is the most useful tool for definitive diagnosis.

Keywords: Hepatic tuberculosis, Pathology, Differential diagnosis, Clinical Management, Case report

Core Tip: Hepatic tuberculosis (TB) is rare in clinical practice and can also be easily missed or misdiagnosed. The clinical symptoms of hepatic TB reported in this case were atypical and a series of investigations were completed in our hospital, including computed-tomography-enhanced scans, magnetic resonance imaging multiparametric scans and pathological examination. We have also conducted a series of discussions on the case, which provide more reference for the diagnosis of hepatic TB in the future.