RESUMEN
The authors report 5 cases of pseudotumoral tuberculosis of the liver. They essentially involved young men from disadvantaged socio-economic backgrounds. Clinically, poor general condition with massive weight loss was constant, while pyrexia and hepatomegaly were sometimes absent. Hepatobiliary ultrasonography revealed hypoechogenic or even anechogenic lesions between 1.5 and 3.5 cm in diameter. Diagnostic confirmation was histological after needle biopsy. The outcome after antibiotic treatment with or without drainage, was recovery, with ultrasonographic normalization of the liver, in all patients, with a mean follow-up of 22 months.
Asunto(s)
Tuberculosis Hepática , Adulto , Antibacterianos/uso terapéutico , Biopsia con Aguja , Terapia Combinada , Diagnóstico Diferencial , Drenaje , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Pobreza , Resultado del Tratamiento , Tuberculosis Hepática/diagnóstico por imagen , Tuberculosis Hepática/patología , Tuberculosis Hepática/terapia , UltrasonografíaRESUMEN
A young man of 27 years was admitted to the medical ward because of increasing ascites over 3 months. There were no signs of portal hypertension and a diagnostic tap produced hemorrhagic liquid. Ultrasound confirmed ascites associated with an abdomino-pelvic mass. Anemia progressed and right aorto-iliac axis arteriography was carried out and demonstrated a poorly vascularised mass. Emergency surgery was carried out and demonstrated an encapsulated firm and cystic abdomino-pelvic mass of 23/18 cm with a rich vascular supply from the greater omentum and a hemoperitoneum of 7 litres secondary to rupture of this pseudo-lymphangiomatous mass. Besides large vessels from the and some loose fibrous adhesions in the pouch of Douglas there was no true implantation site attaching this mass to retroperitoneal structures, gastrointestinal tract or bladder. After ligation of the vessels the entire mass was easily resected. The post-operative course was uncomplicated. Pathological examination confirmed a paraganglioma. A full clinical pathogenic, therapeutic and evolutive study is described.