Misidentification of hepatic tuberculosis as cholangiocarcinoma: A case report

Figure 1 Computed tomography (CT) images of hepatic tuberculosis. A: CT revealed a slightly hypodense mass in the left lobe of the liver and the hilar region, with a few foci of calcification; B: Mild enhancement was observed at the edge in the arterial phase after enhancement; C: The portal vein lesion remained relatively slightly hypodense; D: The main trunk of the portal vein and the right branch of the portal vein were partially visualized in the arterial phase after enhancement.

Figure 2 Magnetic resonance cholangiopancreatography scans of hepatic tuberculosis. A: The lesion showed slightly hypointense signals in T1-weighted images; B: The lesion showed mixed hyperintense and hypointense signals in T2-weighted fat suppressed images; C: The lesion was mildly enhanced at the edge of the arterial phase; D: The margins of the lesion were still mildly enhanced in the portal vein, and no enhancement was seen in the main part of the lesion; E: Premature portal manifestation of the disease was seen in the liver in the arterial phase; F: Mild restricted diffusion was observed; G: The apparent diffusion coefficient value was decreased in the central part of the lesion; H: The left lobe of the liver and the bile ducts in the hilar region were not visualized.

Figure 3 Pathological findings. A: Large coagulative necrosis and granulomatous nodules were seen in the left half of the liver, and the lesions covered almost the entire submitted liver; B: Most of the tissue examined displayed coagulative necrosis, including one piece of liver tissue with focal necrosis and granulomatous nodules around the necrosis, which was considered to indicate a pathogenic microbial infection.