Hepatic and splenic tuberculosis
Citation, DOI, disclosures and article data
At the time the article was created Aditya Shetty had no recorded disclosures.
View Aditya Shetty's current disclosuresAt the time the article was last revised Ashesh Ishwarlal Ranchod had no financial relationships to ineligible companies to disclose.
View Ashesh Ishwarlal Ranchod's current disclosures- Splenic tuberculosis
- Liver tuberculosis
- Hepatic tuberculosis
- Spleen tuberculosis
- Hepatic and splenic tuberculosis (TB)
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 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
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:
References
- 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
- 4. De Backer A, Vanhoenacker F, Mortelé K, Vanschoubroeck I, De Keulenaer B, Parizel P. MRI Features of Focal Splenic Lesions in Patients with Disseminated Tuberculosis. AJR Am J Roentgenol. 2006;186(4):1097-102. doi:10.2214/ajr.05.0032 - Pubmed
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