PRIMARY HEPATIC TUBERCULOSIS

The authors report 11 cases of primary hepatic tuberculosis (PHT), obs erved between January 1982 and December 1996. The mean age of the pati ents was 30 years. Circumstances of discovery were: right upper quadra nt pain (6 cases), chronic fever (4 cases), and cholestatic jaundice ( 1 case). laboratory tests revealed a raised erythrocyte sedimentation rate (9 cases), inflammatory anaemia (7 cases) and an inflammatory tub erculin skin test (4 cases). Ultrasonography allowed a precise morphol ogical investigation, but failed to confirm the diagnosis, which could only be established by pathological examination of biopsies taken dur ing laparoscopy or by ultrasound-guided percutaneous needle biopsy. Di agnostic certainty was therefore obtained in all patients by visualiza tion of a giant cell granuloma with central caseating necrosis. A favo urable course was observed in response to well adapted and well conduc ted specific medical treatment.