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Lim, Kang, Kim, Moon, Ryu, Lee, and Han: A Case of Multi-Organ Macronodular Tuberculosis
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2012; 72(1): 88-92.

Published online: 30 January 2012

DOI: https://doi.org/10.4046/trd.2012.72.1.88

A Case of Multi-Organ Macronodular Tuberculosis

Kyoung Ree Lim, M.D., Myung Ho Kang, M.D., Tae-Suk Kim, M.D., Ki-Won Moon, M.D., Dong Ryeol Ryu, M.D., Hui Young Lee, M.D., Seon-Sook Han, M.D.

Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.

Address for correspondence: Seon-Sook Han, M.D. Department of Internal Medicine, Kangwon National University Hospital, 156, Baengnyeong-ro, Chuncheon 200-722, Korea. Phone: 82-33-258-2377, Fax: 82-33-258-2455, ssunimd@kangwon.ac.kr

Received 26 August 2011       Revised 14 September 2011       Accepted 23 September 2011

Copyright © 2012. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

A 37 year old female presented with epigastric pain and weight loss over a period of 3 months. Her abdominal CT finding showed a 4.5 cm size hepatic mass and 4.3 cm size pancreatic head mass with multiple macronodules in the liver. At the same time, her chest CT revealed a 5 cm size necrotic mass in the left lower lobe of the lung with multiple bilateral pulmonary nodules. We diagnosed these lesions as tuberculosis through multiple biopsies. She was treated with anti-tuberculous medication. After taking the medications, her symptoms were improved. Twelve months later, imaging studies indicated an improvement in the patient's health. Here we report a case report of multi-organ macronodular tuberculosis in lung, liver and pancreas.

Keywords: Tuberculoma, Tuberculosis, Hepatic, Multiple Pulmonary Nodules, Pancreas

Figures and Tables

Figure 1
Simple chest PA showed an approximately 5 cm size consolidation in the retrocardiac area (A, black arrow heads) and nearly complete resolution after treatment (B).
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Figure 2
(A) Abdominal contrast enhanced CT images showed an approximately 4.5 cm size mass (black arrow) in the central liver. (B) Multiple variable size low density masses (black arrow heads) in the liver and a 4.5 cm size mass in the head of the pancreas (white arrow). CT: computed tomography.
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Figure 3
Chest CT images revealed a 5 cm size irregular necrotic mass (white arrow) in LLL (A) and multiple nodules (black arrow heads) in both lungs (B~D). CT: computed tomography; LLL: left lower lobe.
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Figure 4
Microscopic findings of the lesion. (A) Needle biopsy of the lung showed chronic granulomatous inflammation without necrosis (H&E stain, ×100). (B) Needle biopsy of the liver showed chronic granulomatous inflammation with caseous necrosis (arrow) (H&E stain, ×200).
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Figure 5
A follow up chest CT revealed decreased irregular necrotic mass (white arrows) in the lung (A), liver (B), and pancreas head (C). CT: computed tomography.
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