Hepatic and splenic tuberculosis

Last revised by Ashesh Ishwarlal Ranchod on 18 Oct 2023

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)

Non-specific 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 1:

    • multiple

    • small low attenuation areas with central enhancement (acute stage)

    • calcification (chronic stage)

  • macronodular type 1,4:

    • single or multiple tumor-like masses

      • rarely >3 cm in diameter

    • target sign

    • diffuse hepatosplenomegaly

  • T1: lesions are usually isointense when compared to the background parenchyma

  • T2: mixed signal with hyperintense areas

  • T1 C+ (Gd): variable, reflecting the phases of the disease

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Cases and figures

  • Figure 1: spleen
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  • Case 1: macronodular hepatic tuberculosis
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  • Case 2: macronodular hepatic tuberculosis
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  • Case 3: splenic tuberculosis
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  • Case 4
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  • Case 5
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  • Case 6: splenic microabscesses
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  • Case 7: splenic microabscesses
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  • Case 8: calcified hepatic granulomata with comet tail artefact
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