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.
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Pathology
Two types of lesions are known:
- micronodular (common)
- macronodular (rare)
Radiographic features
Ultrasound
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.
CT
- micronodular (miliary) type 3:
- multiple
- small low attenuation areas with central enhancement (acute stage)
- calcification (chronic stage)
- macronodular type 3:
- single or large tumor-like mass
- target sign
- diffuse hepatosplenomegaly
MRI
- 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
Differential diagnosis
- for micronodular type:
- for macronodular type: