Isolated Tubercular Liver Abscess: an entity rarely thought, diagnosed on cytology

Authors

  • Shalini Bahadur NDMC and Hindu Rao Hhospital, New Delhi, India
  • Aastha Narula NDMC and Hindu Rao Hhospital, New Delhi, India
  • Priyanka Anand NDMC and Hindu Rao Hhospital, New Delhi, India
  • Namrata Nargotra NDMC and Hindu Rao Hhospital, New Delhi, India

Keywords:

liver abscess, tuberculosis, rare entity, cytology

Abstract

INTRODUCTION:Tuberculosis is a rare cause of liver abscess in the Indian subcontinent even though the disease itself has high prevalance rates here. Isolated tubercular liver abscess presenting without any other foci of infection is a rare presentation with a documented prevalence of 0.34%. In an adult immune competent patient diagnosis can be challenging as it is likely to be confused with pyogenic and amoebic liver abscess or hepatoma.

CASE HISTORY: A 30 year old female patient presented with complaints of low grade fever, vague abdominal pain of 4 months duration, breathlessness and loss of appetite for 1 month. Past or family history was non-contributory. Ultrasonography abdomen revealed a small hypoechoic lesion in sub-hepatic region of size 49x20mm suggestive of a liver abscess. Computerized Tomographic scan images confirmed loculated irregular collections in and around left lobe of liver and Reidel’s lobe. Fine needle aspiration cytology from the lesion revealed ill formed granulomas on a necrotic background. Zeihl Neelson staining was positive for acid fast bacilli

CONCLUSION: Isolated tubercular liver abscess is a rare entity, particularly in immunocompetent individuals.Symptomatology and radiologic findings may not be contributory. Diagnosis of this entity rests on the demonstration of acid fast bacilli in material obtained. FNAC is a simple minimally invasive, cost effective procedure which helps attain the same.

 

DOI: 10.21276/APALM.1382

Author Biographies

Shalini Bahadur, NDMC and Hindu Rao Hhospital, New Delhi, India

Associate Professer, department of pathology

Aastha Narula, NDMC and Hindu Rao Hhospital, New Delhi, India

senior resident, department of pathology

Priyanka Anand, NDMC and Hindu Rao Hhospital, New Delhi, India

senior resident , department of pathology

Namrata Nargotra, NDMC and Hindu Rao Hhospital, New Delhi, India

head of department , department of pathology

References

1. Kandel, R., Bhattarai, B., & Maharjan, S. Unusual presentation of tuberculosis in an elderly male: a case report. Clinical Case Reports, 2015; 3(1), 43–5.

2.Bhattacharya PK, Roy A, Jamil M, Talukdar KK, Khonglah Y, Sarma K. Isolated Tubercular Subcapsular Liver Abscess: A Rare Manifestation of Extrapulmonary Tuberculosis. Journal of hepatitis. 2015;1(1):1-6.

3.Bangaroo AK, Malhotra AS. Isolated hepatic tuberculosis. J Indian Assoc Paediatr Surg. 2005;10(2):105-7.

4.Rab SM, Beg MZ. Tuberculous liver abscess. Brit J Clin Pract. 1977;31:157-8.

5.Hassani KI, Ousadden A, Ankouz A, Mazaz K, Taleb KA. Isolated liver tuberculosis abscess in a patient without immunodeficiency: A case report. World J Hepatol. 2010;2(9):354-57.

6.Yadav P, Punera DC, Nautiyal R, Kumar A. Tuberculous Liver Abscess with Right Sided Pleural Effusion. Indian Journal of Case Reports. 2015 May 30;1(2):35-7.

7.Bristowe JS. On the connection between abscess of the liver and gastrointestinal ulceration. Trans Pathol Coc. 1858;9:241-52

8.Alvarez SZ. Hepatobiliary tuberculosis. J Gastroenterol Hepatol. 1998;13(8):833-39.

9.Essop AR, Segal I, Posen J, Noormohamed N. Tuberculosis abscess of the liver. A case report. S Afr Med J. 1983;63(21):825-26.

10.Maharaj B, Leary WP, Pudifin DJ. A prospective study of hepatic tuberculosis in 41 black patients. Q J Med. 1987;63(242):517-22.

11.Hayashi M, Yamawaki I, Okajima K, Tomimatsu M, Ohkawa S. Tuberculous liver abscess not associated with lung involvement. Intern Med. 2004;43(6):521-3

12.Kanagaraj A, Marthandam LR, Sriramakrishnan V, Rajesh A, Meenakumari P. Tuberculous Liver Abscess. JAPI. 2008;56:645

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Published

20-10-2017

How to Cite

1.
Bahadur S, Narula A, Anand P, Nargotra N. Isolated Tubercular Liver Abscess: an entity rarely thought, diagnosed on cytology. Ann of Pathol and Lab Med [Internet]. 2017 Oct. 20 [cited 2024 Nov. 19];4(5):C148-151. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/apalm1382

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Section

Case Report