No lesion in the liver can also be hepatic tuberculosis - An important consideration

Hepatic tuberculosis (TB) is rare, but recently it is more frequently detected. On imaging, it presents with different appearances and can mimic a variety of other conditions. A high degree of suspicion combined with appropriate diagnostic modalities and image-guided tissue sampling examination greatly aid in the timely diagnosis of the disease. The sights of this case report are to illustrate and discuss the different presentation of hepatic TB on computed tomography. This entity is frequently related to caseous necrosis, which is the hallmark of this disease. However, our patient didn’t have any liver lesion in spite of deranged liver function tests.

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The Unexpected Diagnosis of Hepatic Tuberculosis in an Immunocompetent Patient

Case Reports in Surgery ◽

10.1155/2020/7915084 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Nikolaos Garmpis ◽

Christos Damaskos ◽

Anna Garmpi ◽

Aliki Liakea ◽

Dimitrios Mantas

Keyword(s):

Clinical Manifestations ◽

Liver Lesion ◽

Immunocompetent Patient ◽

Histological Evaluation ◽

Rare Entity ◽

Liver Malignancies ◽

Caseous Necrosis ◽

Hepatic Tuberculosis ◽

Right Lobe ◽

Specific Symptoms

Background/Aim. Tuberculosis (TB) is a chronic infectious disease which affects millions. The most affected system is the respiratory. Thus, hepatic TB (HTB) without involvement of other organs is not common. Its clinical manifestations are not specific, and both imaging and histopathological findings are necessary for the diagnosis. The differential diagnosis includes primary and metastatic liver malignancies. Our aim is to describe the rare entity of HTB via a case presentation. Patient and Methods. We report a case of a 50-year-old female with abdominal pain, weight loss, fever, and anorexia. All imaging methods described a liver lesion. She underwent right lobe hepatectomy, and the histological evaluation demonstrated granuloma with central caseous necrosis. Results. Seven months postoperatively, the patient remains fit and healthy. Conclusion. HTB is a rare entity with no specific symptoms, signs, and no laboratory nor imaging findings. It can be managed effectively if diagnosed in time or lead to death if left untreated.

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Spontaneous cholecystocutaneous fistula: a rare complication of gallbladder disease

Sao Paulo Medical Journal ◽

10.1590/s1516-31802006000400012 ◽

2006 ◽

Vol 124 (4) ◽

pp. 234-236 ◽

Cited By ~ 10

Author(s):

Ruy Jorge Cruz Junior ◽

Jorge Nahas ◽

Luiz Francisco Poli de Figueiredo

Keyword(s):

Computed Tomography ◽

Case Report ◽

Abdominal Wall ◽

Rare Complication ◽

Gallbladder Disease ◽

Computed Tomography Scan ◽

The Past ◽

The Right ◽

High Degree ◽

Tomography Scan

CONTEXT: Spontaneous cholecystocutaneous abscess or fistula is an extremely uncommon complication secondary to cholecystitis. Over the past 50 years fewer than 20 cases of spontaneous cholecystocutaneous fistulas have been described in the medical literature. We here report a case of subcutaneous gallstone as a rare clinical presentation of the already uncommon cholecystocutaneous fistula. CASE REPORT: An 81-year-old man presented with a large subcutaneous abscess in the right subcostal area with surrounding cellulitis and crepitus. An abdominal computed tomography scan showed two subcutaneous gallstones and communication between the abscess and the gallbladder. Cholecystectomy was performed and the abdominal wall abscess was drained externally. This case report demonstrates that maintaining a high degree of suspicion of this rare entity is helpful in achieving correct preoperative diagnosis, and that computed tomography scan should be performed in all cases of unexplained abdominal wall suppuration or cellulitis.

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The using of megavoltage computed tomography in image-guided brachytherapy for cervical cancer: a case report

Radiation Oncology Journal ◽

10.3857/roj.2015.33.2.155 ◽

2015 ◽

Vol 33 (2) ◽

pp. 155

Author(s):

Ekkasit Tharavichitkul ◽

Suwapim Janla-or ◽

Somsak Wanwilairat ◽

Somvilai Chakrabandhu ◽

Pitchayaponne Klunklin ◽

...

Keyword(s):

Computed Tomography ◽

Cervical Cancer ◽

Case Report ◽

Image Guided ◽

Megavoltage Computed Tomography

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Floral-like enhancement might reflect an active liver tuberculous lesion to avoid systemic hematogenous dissemination by surgery: A case report

Journal of International Medical Research ◽

10.1177/0300060520940158 ◽

2020 ◽

Vol 48 (7) ◽

pp. 030006052094015

Author(s):

Yong-Qian Liu ◽

Wei-Feng Yuan ◽

Xin-Yi Liu ◽

Xin-Xiang Zhao

Keyword(s):

Case Report ◽

Liver Resection ◽

Miliary Tuberculosis ◽

Liver Lesion ◽

The Body ◽

Thigh Muscle ◽

Preoperative Imaging ◽

Caseous Necrosis ◽

Imaging Examination ◽

Tuberculous Abscess

After primary dissemination of Mycobacterium tuberculosis bacillus infection that is localized in liver, disease progression and changes to immune function in the body occur. Various forms of tuberculosis, including granuloma, caseous necrosis, liquefactive necrosis, fibrosis, and calcification, occur that could be presented at different stages, and imaging examination shows findings that are consistent with these stages. Not all liver tuberculosis patients are suitable for liver resection, and preoperative imaging examination and pathological immunohistochemical results could be used to determine whether tuberculosis was active, avoid unnecessary liver resection, and prevent the postoperative spread of tuberculosis. Here, we reported a case of miliary tuberculosis, pelvic tuberculosis, and tuberculous abscess of the thigh muscle in a 51-year-old man after liver lesion resection. The liver lesion was confirmed to be tuberculosis by surgical pathology, which is rare and has not been previously reported. The purpose of this case report is to remind radiologists of the importance of the floral-like enhancement and to estimate whether liver tuberculosis is active. This will help to guide clinicians to determine the timing of surgery, avoid unnecessary liver resection, and avoid hematogenous transmission.

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“CBCT-THE THIRD AND THE MOST DIAGNOSTIC DIMENSION”: A CASE REPORT

10.36106/gjra/9411934 ◽

2021 ◽

pp. 85-87

Author(s):

Rudrax Jindal ◽

Rekha Gupta ◽

Divyajoti Das ◽

Abhishek Kumar Gupta

Keyword(s):

Computed Tomography ◽

Case Report ◽

Cone Beam ◽

Root Fracture ◽

Vertical Root Fracture ◽

Naked Eye ◽

The Third ◽

Diagnostic Modalities ◽

Cause Of Pain ◽

Over Time

Radiology is an essential tool in the dental clinical practice as most structures harbouring disease are not visible to the naked eye. There are various entities that are generally not noticed until periapical pathology occurs. Under such circumstances, the diagnosis is difcult, as they mimic various other conditions. One of such condition is root fracture after an endodontic treatment of tooth. Vertical root fracture (VRF) usually starts from an internal dentinal crack and develops over time, due to masticatory forces and occlusal loads. Here in this paper we will discuss how we stepwise diagnostic radiographic modalities are used to see the actual cause of pain in a 60 year old male patient. Cone Beam Computed Tomography (CBCT) was done to view in 3D which revealed VRF of tooth. Throughout the paper the edge of CBCT over other diagnostic modalities is discussed till we get our diagnosis.

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Case Report: Fusion of positron emission tomography (PET) and computed tomography (CT) images for image-guided endoscopic navigation in maxillofacial surgery: Clinical application of a new technique

Journal of Cranio-Maxillofacial Surgery ◽

10.1016/j.jcms.2007.05.004 ◽

2007 ◽

Vol 35 (6-7) ◽

pp. 322-328 ◽

Cited By ~ 9

Author(s):

Matthias Feichtinger ◽

Reingard Maria Aigner ◽

Gert Santler ◽

Hans Kärcher

Keyword(s):

Computed Tomography ◽

Positron Emission Tomography ◽

Case Report ◽

Clinical Application ◽

Maxillofacial Surgery ◽

Emission Tomography ◽

New Technique ◽

Image Guided ◽

Positron Emission ◽

A New Technique

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Transient Prealbumin- Associated Hyperthyroxinemia in TSH-Producing Pituitary Adenoma

Nuklearmedizin ◽

10.1055/s-0038-1629511 ◽

1990 ◽

Vol 29 (01) ◽

pp. 40-43 ◽

Cited By ~ 3

Author(s):

W. Langsteger ◽

P. Költringer ◽

P. Wakonig ◽

B. Eber ◽

M. Mokry ◽

...

Keyword(s):

Computed Tomography ◽

Case Report ◽

Pituitary Adenoma ◽

Thyroid Hormones ◽

Protein Binding ◽

Alpha Subunit ◽

Normal Range ◽

Thyroxine Binding Globulin ◽

Free Thyroid Hormones ◽

Transmission Computed Tomography

This case report describes a 38-year-old male who was hospitalized for further clarification of clinically mild hyperthyroidism. His increased total hormone levels, the elevated free thyroid hormones and the elevated basal TSH with blunted response to TRH strongly suggested a pituitary adenoma with inappropriate TSH incretion. Transmission computed tomography showed an intrasellar expansion, 16 mm in diameter. The neoplastic TSH production was confirmed by an elevated alpha-subunit and a raised molar alpha-sub/ATSH ratio. However, T4 distribution on prealbumin (PA, TTR), albumin (A) and thyroxine binding globulin (TBG) showed a clearly increased binding to PA (39%), indicating additional prealbumin-associated hyperthyroxinemia. The absolute values of PA, A and TBG were within the normal range. After removal of the TSH-producing adenoma, basal TSH, the free thyroid hormones and T4 binding to prealbumin returned to normal. Therefore, the prealbumin-associated hyperthyroxinemia had to be interpreted as a transitory phenomenon related to secondary hyperthyroidism (T4 shift from thyroxine binding globulin to prealbumin) rather than a genetically conditioned anomaly of protein binding.

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