Hepatic space-occupying lesions due to tuberculosis. A review of five cases.

Macronodular tuberculosis of the liver, a rare condition even in countries where tuberculosis is endemic, raises unique diagnostic challenges because of its nonspecific clinical and radiological manifestations and of the diff iculty of obtaining the presurgical biopsies needed as a basis for therapeu tic decisions. Five surgically-treated cases are reviewed. Chest radiograph s were normal in all five patients. The diagnosis was made unexpectedly dur ing or after surgery in three patients initially thought to have hepatocell ular carcinoma, liver metastases, or hydatid cyst (one case each). Intraope rative histology is essential to avoid unnecessary liver resection in this condition that usually responds well to pharmacologic therapy.