Abdominal wall and retroperitoneal tuberculosis
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Very large left periaortic nodal conglomerate measuring 7 x 6 cm, encasing and perhaps narrowing the left renal artery, likely resulting in some narrowing of the left renal vein as well. Other smaller periureteric nodes are present bilaterally. There is abnormal soft tissue extending inferiorly between the aorta and inferior vena cava. 5 x 3 cm subxiphoid abdominal wall collection containing primarily fluid with some areas of soft tissue thickening posteriorly.
This patient presented in an endemic area for TB and thus TB lymphadenitis was felt to be the most likely cause. The subxiphoid collection underwent incision and drainage, with the final pathology reporting positive staining for acid-fast bacilli, confirming the diagnosis of TB.