肝脏结核1例并文献复习
|
摘要
目的了解肝脏结核的临床特征。方法对1例肝结核患者的临床表现、实验室检查结果、治疗及预后进行分析,并以"Liver/Hepatology/Hepatic Tuberculosis"为关键词,检索2013-2017年Pubmed数据库关于肝结核的文献,筛选并总结分析肝结核患者的临床资料。结果该例16岁男性患者以咳嗽、腹胀为主要表现,痰查抗酸杆菌阳性,CT提示肝脏低密度占位性病变,经抗结核治疗后病变消失,最终考虑血行播散性结核所致肝结核。通过文献复习并结合本例患者,共64例患者,其中男38例,女26例,年龄11月龄～77岁,合并其他部位结核或存在基础疾病者39例,主要临床表现有:发热33例(51.6%)、腹痛32例(50.0%)、体重下降20例(31.2%)、食欲减退16例(25.0%)、疲乏无力14例(21.9%)和恶心/呕吐13例(20.3%),CT表现主要为肝脏局部低密度占位性病变,59例患者经病理/细菌学诊断,5例患者经诊断性抗结核治疗有效后诊断。治愈36例,好转19例,死亡3例。结论肝结核临床症状不典型,影像学结合肝脏病理组织学检查是诊断肝结核的主要方法,抗结核治疗及适时手术治疗为有效治疗手段,预后大多良好。
Objective To understand the clinical features of hepatic tuberculosis. Methods The clinical manifestations,laboratory findings, treatment, and prognosis of a case of hepatic tuberculosis were analyzed. Similar cases were identified from PubMed database during the period from 2013 to 2017 using search terms "Liver/Hepatology/Hepatic Tuberculosis". The clinical data of the identified patients with hepatic tuberculosis were reviewed and analyzed. Results The 16-year-old male patient presented with cough and abdominal distension. His sputum was positive for acid-fast bacillus. CT showed low-density spaceoccupying lesions. After anti-tuberculosis treatment, the lesion disappeared. Hepatic tuberculosis was finally considered, which was caused by disseminated tuberculosis. Literature search identified 63 similar cases. In summary, the 64 cases(containing this one)included 38 males and 26 females with age from 11 months to 77 years. Tuberculosis in other site or underlying disease was found in 39 cases. The main clinical manifestations were fever(51.6%), abdominal pain(50.0%), weight loss(31.2%), loss of appetite(25.0%), tiredness/weakness(21.9%), and nausea/vomiting(20.3%). Low-density space-occupying lesions were the main features on CT image. The diagnosis was confirmed by histopathological and/or bacteriological testing in 59 patients. Five patients were diagnosed after diagnostic anti-tuberculosis treatment was effective. Overall, 36 patients were cured, 19 improved, and 3 died.Conclusions The clinical symptoms of hepatic tuberculosis are atypical. Imaging combined with histopathological examination of the liver is the preferred method for diagnosis of hepatic tuberculosis. Anti-tuberculosis treatment and timely surgical treatment is usually effective with good outcomes.
Objective To understand the clinical features of hepatic tuberculosis. Methods The clinical manifestations,laboratory findings, treatment, and prognosis of a case of hepatic tuberculosis were analyzed. Similar cases were identified from PubMed database during the period from 2013 to 2017 using search terms "Liver/Hepatology/Hepatic Tuberculosis". The clinical data of the identified patients with hepatic tuberculosis were reviewed and analyzed. Results The 16-year-old male patient presented with cough and abdominal distension. His sputum was positive for acid-fast bacillus. CT showed low-density spaceoccupying lesions. After anti-tuberculosis treatment, the lesion disappeared. Hepatic tuberculosis was finally considered, which was caused by disseminated tuberculosis. Literature search identified 63 similar cases. In summary, the 64 cases(containing this one)included 38 males and 26 females with age from 11 months to 77 years. Tuberculosis in other site or underlying disease was found in 39 cases. The main clinical manifestations were fever(51.6%), abdominal pain(50.0%), weight loss(31.2%), loss of appetite(25.0%), tiredness/weakness(21.9%), and nausea/vomiting(20.3%). Low-density space-occupying lesions were the main features on CT image. The diagnosis was confirmed by histopathological and/or bacteriological testing in 59 patients. Five patients were diagnosed after diagnostic anti-tuberculosis treatment was effective. Overall, 36 patients were cured, 19 improved, and 3 died.Conclusions The clinical symptoms of hepatic tuberculosis are atypical. Imaging combined with histopathological examination of the liver is the preferred method for diagnosis of hepatic tuberculosis. Anti-tuberculosis treatment and timely surgical treatment is usually effective with good outcomes.
引文
[1] EVANS R P, MOURAD M M, DVORKIN L, et al. Hepatic and intra-abdominal tuberculosis:2016 update[J]. Curr Infect Dis Rep, 2016, 18(12):45.
[2] REED D H, NASH A F, VALABHJI P. Radiological diagnosis and management of a solitary tuberculous hepatic abscess[J]. Br J Radiol,1990, 63(755):902-904.
[3] PANDEY A, SINGH R K. Focal liver tuberculosis:a case report[J]. Indian J Surg, 2014, 76(3):223-227.
[4] GERAMIZADEH B, NIKEGHBALLAN S, JANGHORBAN P,et al. Isolated tuberculosis of transplanted liver, a case report and review of the literature[J]. Hepat Mon, 2013, 13(5):e6691.
[5] MUSUMBA C,DEY D,RICHARDSON P. Atypical presentation of miliary tuberculosis with hepatic involvement early after renal transplantation[J]. Clin Gastroenterol Hepatol,2013, 11(7):e52-53.
[6] BHATT G C, NANDAN D, SINGH S. Isolated tuberculous liver abscess in immunocompetent children-report of two cases[J].Pathog Glob Health, 2013, 107(1):35-37.
[7] HANAFIAH M, ALHABSHI S M, BAG T, et al. Probable hepatic tuberculosis masquerading as Klatskin tumour in an immunocompetent patient[J]. BMJ Case Rep,2013,2013:bcr2013010262.
[8] ZORBAS K, KOUTOULIDIS V, FOUKAS P, et al.Hepatic tuberculoma mimicking hepatocellular carcinoma in an immunocompetent host[J]. BMJ Case Rep, 2013, 2013bcr2013008775.
[9] KIM T K, CHOI C W, HA J K, et al. A case of tuberculous liver abscess developed during chemotherapy for tuberculous peritonitis as paradoxical response[J]. Korean J Gastroenterol,2013, 62(1):64-68.
[10] HAFEZI AHMADI M, TEIMOURI H, ALIZADEH S. The liver metastatic adenocarcinoma of colorectal cancer with synchronous isolated hepatic tuberculosis[J]. Hepat Mon, 2013, 13(5):e9844.
[11] BOSCH W, POOWANAWITTAYAKOM N,CHAIKRIANGKRAI K, et al. Tuberculous hepatitis in renal transplant recipients following alemtuzumab induction therapy[J]. Transpl Infect Dis, 2013, 15(1):E33-E39.
[12] WU Z, WANG W L, ZHU Y, et al. Diagnosis and treatment of hepatic tuberculosis:report of five cases and review of literature.[J]. Int J Clin Exp Med, 2013, 6(9):845-850.
[13] NANDAN D,BHATT G C,DEWAN V,et al. Isolated tuberculous liver abscess in a 3-year-old immunocompetent child[J]. Paediatr Int Child Health, 2013, 33(3):187-189.
[14] CHEN T C, CHOU L T, HUANG C C, et al. Isolated tuberculous liver abscess in an immunocompetent adult patient:A case report and literature review[J]. J Microbiol Immunol Infect, 2016, 49(3):455-458.
[15] SINGH R,KUMAR N,SUNDRIYAL D,et al. Mixed pyogenic and tuberculous liver abscess:clinical suspicion is what matters[J]. BMJ Case Rep, 2013, 2013:bcr2013008768.
[16] KANDEL R, BHATTARAI B, MAHARJAN S. Unusual presentation of tuberculosis in an elderly male:a case report[J].Clin Case Rep, 2015, 3(1):43-45.
[17] MOURAD M M,LIOSSIS C,ALGARNI A,et al. Primary hepatic tuberculosis in immunocompetent adults:a UK case series[J]. Oxf Med Case Reports, 2014, 2014(9):148-150.
[18] SHASTRI M, KAUSADIKAR S, JARIWALA J, et al. Isolated hepatic tuberculosis:An uncommon presentation of a common culprit[J]. Australas Med J, 2014, 7(6):247-250.
[19] LIMAIEM F, GARGOURI F, BOURAOUI S, et al. Coexistence of hepatocellular carcinoma and hepatic tuberculosis[J].Surg Infect, 2014, 15(4):437-440.
[20] TURKEL KUCUKMETIN N, INCE U, CICEK B, et al.Isolated hepatic tuberculosis:a rare cause of hepatic mass lesions[J]. Turk J Gastroenterol, 2014, 25(1):110-112.
[21] JAIN D, AGGARWAL H K, JAIN P, et al. Primary hepatic tuberculosis presenting as acute liver failure[J]. Oxf Med Case Reports, 2014, 2014(9):153-155.
[22] YU H Y, SHENG J F. Liver tuberculosis presenting as an uncommon cause of pyrexia of unknown origin:positron emission tomography/computed tomography identifies the correct site for biopsy[J]. Med Princ Pract, 2014, 23(6):577-579.
[23] KHARRASSE G, SOUFI M, BEREKHLI H, et al. Primarytuberculoma of the liver:a case report and literature review[J].Pan Afr Med J,2014,19:321.
[24] OGURA T, KURISU Y, MASUDA D, et al. Giant liver cyst caused by tuberculosis infection and masquerading as malignant peritonitis[J]. Endoscopy, 2014, 46(Suppl 1):E191-192.
[25] ZHANG L,YANG N B,NI S L,et al. A case of multiple macronodular hepatic tuberculosis difficult to differentiate from hepatocellular carcinoma with intrahepatic metastasis:CTguided fine needle aspiration biopsy confirmed the diagnosis[J].Int J Clin Exp Pathol, 2014, 7(11):8240-8244.
[26] SHOKOUHI S,TOOLABI K,TEHRANI S,et al. Tuberculous liver abscess in an immunocompetent patient:a case report[J].Tanaffos,2014, 13(3):49-51.
[27] ANANDPARA K M, ASWANI Y, HIRA P. Primary hepatic tubercular abscesses in an immunocompetent patient[J]. BMJ Case Rep, 2014, 2014:bcr2014207855.
[28] SANZ-CANALEJAS L, GOMEZ-MAMPASO E, CANTONMORENO R, et al. Peliosis hepatis due to disseminated tuberculosis in a patient with AIDS[J]. Infection, 2014, 42(1):185-189.
[29] PETRESCU I O,GHEONEA C,VOICAN C S,et al.Disseminated tuberculosis presenting as febrile seizures with fatal evolution in an infant[J]. Rom J Morphol Embryol, 2014,55(4):1483-1489.
[30] ZHU H,SHU D,MEI Y,et al. Primary liver tuberculoma:a case report[J]. Zhonghua Gan Zang Bing Za Zhi, 2014, 22(4):307-308.
[31] YAO Y, LI S. A case report of hepatic tuberculosis[J]. Zhonghua Gan Zang Bing Za Zhi, 2014, 22(7):548-549.
[32] PARK J I. Primary hepatic tuberculosis mimicking intrahepatic cholangiocarcinoma:report of two cases[J]. Ann Surg Treat Res, 2015, 89(2):98-101.
[33] MEENA M,DIXIT R,MEENA L P,et al. Primary/local hepatic tuberculosis without dissemination[J]. BMJ Case Rep,2015, 2015:bcr2014206974.
[34] TRUONG L N, O'CONNELL R, OREN A. a 49-year-old man with fever, erythema nodosum, and ankle swelling[J]. Ann Am Thorac Soc, 2015, 12(10):1575-1577.
[35] HUSAIN M, KHAN S, HASS AN M J. Hepatic tuberculosis mimicking metastasis in a case of carcinoma sigmoid colon[J]. J Lab Physicians, 2015, 7(1):64-66.
[36] SHARMA R, DEY A K, MITTAL K, et al. Hepatic tuberculosis mimicking biliary cystadenoma:a radiological dilemma[J].Case Rep Surg, 2015, 2015:390184.
[37] HUNG Y M, HUANG N C, WANG J S, et al. Isolated hepatic tuberculosis mimicking liver tumors in a dialysis patient[J].Hemodial Int, 2015, 19(2):344-346.
[38] HASAN R, KUMAR S, MATHEW M, et al. Isolated hepatosplenic tuberculosis:a rare presentation[J]. BMJ Case Reports, 2015, 2015:bcr2015211065.
[39] LIAO J R, ZHANG D, WU X L. Pulmonary tuberculosis combined with hepatic tuberculosis:a case report and literature review[J]. Clin Respir J, 2015, 9(4):501-505.
[40] SUTHAR P P, BUMIYA R G, PATEL K, et al. Incidental diagnosis of liver tuberculosis in a patient with jaundice[J]. BMJ Case Reports, 2015, 2015:bcr2014206866.
[41] TOPTAS T, ILHAN B, BILGIN H, et al. Miliary tuberculosis induced acute liver failure[J]. Case Rep Infect Dis, 2015, 2015:759341.
[42] CARRARA E,BRUNETTI E,DI MATTED A, et al.Tubercular liver abscess:an uncommon presentation of disseminated tuberculosis[J]. Infection, 2015, 43(2):237-240.
[43] BISWAS B K, PAL S, MOULIK D J, et al. Isolated hepatic tuberculoma-a case report[J]. Iranian J Pathol, 2016, 11(5):427-430.
[44] PATEL R, CHOKSI D, PODDAR P, et al. Primary tubercular liver abscess complicated by tubercular meningitis in portal cavernoma cholangiopathy[J]. ACG Case Rep J, 2016, 3(4):e196.
[45] DIALLO I, MBENGUE A, GNING S B, et al. Hepatosplenic tuberculosis simulating secondary malignant lesions with cholangitis[J]. BMC Res Notes, 2016, 9:316.
[46] IWASAKI T,NAGASHIMA A,NAKATSUKA H,et al.Localized hepatic tuberculosis with imaging changes caused by the progression of tuberculosis[J]. Intern Med, 2016, 55(6):613-616.
[47] RIBEIRO R, PATRICIO C, PAIS DA SILVA F, et al. Erythema induratum of Bazin and Poncet's arthropathy as epiphenomena of hepatic tuberculosis[J]. BMJ Case Rep, 2016, 2016:bcr2015213585.
[48] RIBEIRO S, TRABULO D, CARDOSO C, et al. Disseminatedtuberculosis in an immunocompetent patient:the answer is in the liver[J]. GE Port J Gastroenterol, 2015, 23(4):208-213.
[49] BOURGAIN G, SBAI W, LUCIANO L, et al. Hepatoperitoneal tuberculosis with negative interferon gamma assay(Quantiferon TM)in an immunocompetent patient:A case report[J]. Clin Res Hepatol Gastroenterol, 2016, 40(4):e44-e45.
[50] ZHANG L, HAN C, HAN Z, et al. Two rare cases involving the spread of tuberculosis:a tuberculous abscess of the chest wall invading the liver by way of the diaphragm[J]. Intern Med,2016, 55(16):2237-2239.
[51] PANDYA J S,KANDEKAR R V,TIWARI A R,et al. Primary liver abscess with anterior abdominal wall extension caused by mycobacterium tuberculosis complex[J]. J Clin Diagn Res,2016, 10(11):PD08-PD09.
[52] KHANIJO S, TANDON P. A case of hepatic tuberculosis:a tuberculoma[J]. Indian J Tubere, 2018, 65(1):91-93.
[53] LIU H, ZHU J, DONG H, et al. Isolated hepatic tuberculosis in the caudate lobe mimicking intrahepatic carcinoma[J]. Clin Res Hepatol Gastroenterol, 2017, 41(5):e65-e67.
[54] ZHAO Z, LEOW W Q. Concurrent hepatic tuberculosis and hepatic graft-versus-host disease in an allogeneic hematopoietic stem cell transplant recipient:a case report[J]. Transplant Proc,2017, 49(7):1659-1662.
[55] KUMAR P, TANEJA S, GUPTA K, et al. Unusual presentation of tubercular liver abscess in an immune-competent adult[J]. J Clin Exp Hepatol, 2017, 7(1):77-79.
[56]邹高伟,张亚林,廖荣信,等.肝脏结核的CT表现[J].中国现代医学杂志,2013, 23(36):81-86.
[2] REED D H, NASH A F, VALABHJI P. Radiological diagnosis and management of a solitary tuberculous hepatic abscess[J]. Br J Radiol,1990, 63(755):902-904.
[3] PANDEY A, SINGH R K. Focal liver tuberculosis:a case report[J]. Indian J Surg, 2014, 76(3):223-227.
[4] GERAMIZADEH B, NIKEGHBALLAN S, JANGHORBAN P,et al. Isolated tuberculosis of transplanted liver, a case report and review of the literature[J]. Hepat Mon, 2013, 13(5):e6691.
[5] MUSUMBA C,DEY D,RICHARDSON P. Atypical presentation of miliary tuberculosis with hepatic involvement early after renal transplantation[J]. Clin Gastroenterol Hepatol,2013, 11(7):e52-53.
[6] BHATT G C, NANDAN D, SINGH S. Isolated tuberculous liver abscess in immunocompetent children-report of two cases[J].Pathog Glob Health, 2013, 107(1):35-37.
[7] HANAFIAH M, ALHABSHI S M, BAG T, et al. Probable hepatic tuberculosis masquerading as Klatskin tumour in an immunocompetent patient[J]. BMJ Case Rep,2013,2013:bcr2013010262.
[8] ZORBAS K, KOUTOULIDIS V, FOUKAS P, et al.Hepatic tuberculoma mimicking hepatocellular carcinoma in an immunocompetent host[J]. BMJ Case Rep, 2013, 2013bcr2013008775.
[9] KIM T K, CHOI C W, HA J K, et al. A case of tuberculous liver abscess developed during chemotherapy for tuberculous peritonitis as paradoxical response[J]. Korean J Gastroenterol,2013, 62(1):64-68.
[10] HAFEZI AHMADI M, TEIMOURI H, ALIZADEH S. The liver metastatic adenocarcinoma of colorectal cancer with synchronous isolated hepatic tuberculosis[J]. Hepat Mon, 2013, 13(5):e9844.
[11] BOSCH W, POOWANAWITTAYAKOM N,CHAIKRIANGKRAI K, et al. Tuberculous hepatitis in renal transplant recipients following alemtuzumab induction therapy[J]. Transpl Infect Dis, 2013, 15(1):E33-E39.
[12] WU Z, WANG W L, ZHU Y, et al. Diagnosis and treatment of hepatic tuberculosis:report of five cases and review of literature.[J]. Int J Clin Exp Med, 2013, 6(9):845-850.
[13] NANDAN D,BHATT G C,DEWAN V,et al. Isolated tuberculous liver abscess in a 3-year-old immunocompetent child[J]. Paediatr Int Child Health, 2013, 33(3):187-189.
[14] CHEN T C, CHOU L T, HUANG C C, et al. Isolated tuberculous liver abscess in an immunocompetent adult patient:A case report and literature review[J]. J Microbiol Immunol Infect, 2016, 49(3):455-458.
[15] SINGH R,KUMAR N,SUNDRIYAL D,et al. Mixed pyogenic and tuberculous liver abscess:clinical suspicion is what matters[J]. BMJ Case Rep, 2013, 2013:bcr2013008768.
[16] KANDEL R, BHATTARAI B, MAHARJAN S. Unusual presentation of tuberculosis in an elderly male:a case report[J].Clin Case Rep, 2015, 3(1):43-45.
[17] MOURAD M M,LIOSSIS C,ALGARNI A,et al. Primary hepatic tuberculosis in immunocompetent adults:a UK case series[J]. Oxf Med Case Reports, 2014, 2014(9):148-150.
[18] SHASTRI M, KAUSADIKAR S, JARIWALA J, et al. Isolated hepatic tuberculosis:An uncommon presentation of a common culprit[J]. Australas Med J, 2014, 7(6):247-250.
[19] LIMAIEM F, GARGOURI F, BOURAOUI S, et al. Coexistence of hepatocellular carcinoma and hepatic tuberculosis[J].Surg Infect, 2014, 15(4):437-440.
[20] TURKEL KUCUKMETIN N, INCE U, CICEK B, et al.Isolated hepatic tuberculosis:a rare cause of hepatic mass lesions[J]. Turk J Gastroenterol, 2014, 25(1):110-112.
[21] JAIN D, AGGARWAL H K, JAIN P, et al. Primary hepatic tuberculosis presenting as acute liver failure[J]. Oxf Med Case Reports, 2014, 2014(9):153-155.
[22] YU H Y, SHENG J F. Liver tuberculosis presenting as an uncommon cause of pyrexia of unknown origin:positron emission tomography/computed tomography identifies the correct site for biopsy[J]. Med Princ Pract, 2014, 23(6):577-579.
[23] KHARRASSE G, SOUFI M, BEREKHLI H, et al. Primarytuberculoma of the liver:a case report and literature review[J].Pan Afr Med J,2014,19:321.
[24] OGURA T, KURISU Y, MASUDA D, et al. Giant liver cyst caused by tuberculosis infection and masquerading as malignant peritonitis[J]. Endoscopy, 2014, 46(Suppl 1):E191-192.
[25] ZHANG L,YANG N B,NI S L,et al. A case of multiple macronodular hepatic tuberculosis difficult to differentiate from hepatocellular carcinoma with intrahepatic metastasis:CTguided fine needle aspiration biopsy confirmed the diagnosis[J].Int J Clin Exp Pathol, 2014, 7(11):8240-8244.
[26] SHOKOUHI S,TOOLABI K,TEHRANI S,et al. Tuberculous liver abscess in an immunocompetent patient:a case report[J].Tanaffos,2014, 13(3):49-51.
[27] ANANDPARA K M, ASWANI Y, HIRA P. Primary hepatic tubercular abscesses in an immunocompetent patient[J]. BMJ Case Rep, 2014, 2014:bcr2014207855.
[28] SANZ-CANALEJAS L, GOMEZ-MAMPASO E, CANTONMORENO R, et al. Peliosis hepatis due to disseminated tuberculosis in a patient with AIDS[J]. Infection, 2014, 42(1):185-189.
[29] PETRESCU I O,GHEONEA C,VOICAN C S,et al.Disseminated tuberculosis presenting as febrile seizures with fatal evolution in an infant[J]. Rom J Morphol Embryol, 2014,55(4):1483-1489.
[30] ZHU H,SHU D,MEI Y,et al. Primary liver tuberculoma:a case report[J]. Zhonghua Gan Zang Bing Za Zhi, 2014, 22(4):307-308.
[31] YAO Y, LI S. A case report of hepatic tuberculosis[J]. Zhonghua Gan Zang Bing Za Zhi, 2014, 22(7):548-549.
[32] PARK J I. Primary hepatic tuberculosis mimicking intrahepatic cholangiocarcinoma:report of two cases[J]. Ann Surg Treat Res, 2015, 89(2):98-101.
[33] MEENA M,DIXIT R,MEENA L P,et al. Primary/local hepatic tuberculosis without dissemination[J]. BMJ Case Rep,2015, 2015:bcr2014206974.
[34] TRUONG L N, O'CONNELL R, OREN A. a 49-year-old man with fever, erythema nodosum, and ankle swelling[J]. Ann Am Thorac Soc, 2015, 12(10):1575-1577.
[35] HUSAIN M, KHAN S, HASS AN M J. Hepatic tuberculosis mimicking metastasis in a case of carcinoma sigmoid colon[J]. J Lab Physicians, 2015, 7(1):64-66.
[36] SHARMA R, DEY A K, MITTAL K, et al. Hepatic tuberculosis mimicking biliary cystadenoma:a radiological dilemma[J].Case Rep Surg, 2015, 2015:390184.
[37] HUNG Y M, HUANG N C, WANG J S, et al. Isolated hepatic tuberculosis mimicking liver tumors in a dialysis patient[J].Hemodial Int, 2015, 19(2):344-346.
[38] HASAN R, KUMAR S, MATHEW M, et al. Isolated hepatosplenic tuberculosis:a rare presentation[J]. BMJ Case Reports, 2015, 2015:bcr2015211065.
[39] LIAO J R, ZHANG D, WU X L. Pulmonary tuberculosis combined with hepatic tuberculosis:a case report and literature review[J]. Clin Respir J, 2015, 9(4):501-505.
[40] SUTHAR P P, BUMIYA R G, PATEL K, et al. Incidental diagnosis of liver tuberculosis in a patient with jaundice[J]. BMJ Case Reports, 2015, 2015:bcr2014206866.
[41] TOPTAS T, ILHAN B, BILGIN H, et al. Miliary tuberculosis induced acute liver failure[J]. Case Rep Infect Dis, 2015, 2015:759341.
[42] CARRARA E,BRUNETTI E,DI MATTED A, et al.Tubercular liver abscess:an uncommon presentation of disseminated tuberculosis[J]. Infection, 2015, 43(2):237-240.
[43] BISWAS B K, PAL S, MOULIK D J, et al. Isolated hepatic tuberculoma-a case report[J]. Iranian J Pathol, 2016, 11(5):427-430.
[44] PATEL R, CHOKSI D, PODDAR P, et al. Primary tubercular liver abscess complicated by tubercular meningitis in portal cavernoma cholangiopathy[J]. ACG Case Rep J, 2016, 3(4):e196.
[45] DIALLO I, MBENGUE A, GNING S B, et al. Hepatosplenic tuberculosis simulating secondary malignant lesions with cholangitis[J]. BMC Res Notes, 2016, 9:316.
[46] IWASAKI T,NAGASHIMA A,NAKATSUKA H,et al.Localized hepatic tuberculosis with imaging changes caused by the progression of tuberculosis[J]. Intern Med, 2016, 55(6):613-616.
[47] RIBEIRO R, PATRICIO C, PAIS DA SILVA F, et al. Erythema induratum of Bazin and Poncet's arthropathy as epiphenomena of hepatic tuberculosis[J]. BMJ Case Rep, 2016, 2016:bcr2015213585.
[48] RIBEIRO S, TRABULO D, CARDOSO C, et al. Disseminatedtuberculosis in an immunocompetent patient:the answer is in the liver[J]. GE Port J Gastroenterol, 2015, 23(4):208-213.
[49] BOURGAIN G, SBAI W, LUCIANO L, et al. Hepatoperitoneal tuberculosis with negative interferon gamma assay(Quantiferon TM)in an immunocompetent patient:A case report[J]. Clin Res Hepatol Gastroenterol, 2016, 40(4):e44-e45.
[50] ZHANG L, HAN C, HAN Z, et al. Two rare cases involving the spread of tuberculosis:a tuberculous abscess of the chest wall invading the liver by way of the diaphragm[J]. Intern Med,2016, 55(16):2237-2239.
[51] PANDYA J S,KANDEKAR R V,TIWARI A R,et al. Primary liver abscess with anterior abdominal wall extension caused by mycobacterium tuberculosis complex[J]. J Clin Diagn Res,2016, 10(11):PD08-PD09.
[52] KHANIJO S, TANDON P. A case of hepatic tuberculosis:a tuberculoma[J]. Indian J Tubere, 2018, 65(1):91-93.
[53] LIU H, ZHU J, DONG H, et al. Isolated hepatic tuberculosis in the caudate lobe mimicking intrahepatic carcinoma[J]. Clin Res Hepatol Gastroenterol, 2017, 41(5):e65-e67.
[54] ZHAO Z, LEOW W Q. Concurrent hepatic tuberculosis and hepatic graft-versus-host disease in an allogeneic hematopoietic stem cell transplant recipient:a case report[J]. Transplant Proc,2017, 49(7):1659-1662.
[55] KUMAR P, TANEJA S, GUPTA K, et al. Unusual presentation of tubercular liver abscess in an immune-competent adult[J]. J Clin Exp Hepatol, 2017, 7(1):77-79.
[56]邹高伟,张亚林,廖荣信,等.肝脏结核的CT表现[J].中国现代医学杂志,2013, 23(36):81-86.