Hepatic and splenic tuberculosis
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Hepatic and splenic tuberculosis refers to tuberculosis affecting the liver and the spleen. It generally occurs due to hematogenous spread from the primary site of infection, commonly from pulmonary tuberculosis.
Two types of lesions are known:
- micronodular (common)
- macronodular (rare)
Nonspecific features are usually seen, including hepatosplenomegaly and abscesses 3.
There may be small hypoechoic nodules (miliary type) or larger hypoechoic mass-like areas 2,3.
- micronodular (miliary) type 3
- small low attenuation areas with central enhancement (acute stage)
- calcification (chronic stage)
- macronodular type 3
- single or large tumor-like mass
- diffuse hepatosplenomegaly
- T1: lesions usually isointense when compared to the background parenchyma
- T2: mixed signal with hyperintense areas
- C+ (Gd): variable, reflecting the phases of the disease
- 1. Harisinghani MG, McLoud TC, Shepard JA et-al. Tuberculosis from head to toe. Radiographics. 2000;20 (2): 449-70. doi:10.1148/radiographics.20.2.g00mc12449 - Pubmed citation
- 2. Hickey AJ, Gounder L, Moosa MY, Drain PK. A systematic review of hepatic tuberculosis with considerations in human immunodeficiency virus co-infection. BMC infectious diseases. 15: 209. doi:10.1186/s12879-015-0944-6 - Pubmed
- 3. Lee HJ, Kim JW, Hong JH, Kim GS, Shin SS, Heo SH, Lim HS, Hur YH, Seon HJ, Jeong YY. Cross-sectional Imaging of Splenic Lesions: RadioGraphics Fundamentals | Online Presentation. (2018) Radiographics : a review publication of the Radiological Society of North America, Inc. 38 (2): 435-436. doi:10.1148/rg.2018170119 - Pubmed