Porta hepatis tuberculous lymphadenopathy(TL)is rare,and the clinical and imaging manifestations often mimic tumors.To offer a bet-ter understanding of porta hepatis TL and thus improve its diagnosis and treatment,her...Porta hepatis tuberculous lymphadenopathy(TL)is rare,and the clinical and imaging manifestations often mimic tumors.To offer a bet-ter understanding of porta hepatis TL and thus improve its diagnosis and treatment,here,we retrospectively reviewed and analyzed 10 porta hepatis TL cases between May 2017 and November 2022.In this study,porta hepatis TL occurred predominantly in women(70%),with a mean age of 43.1 years(range,16-70 years).Among the patients,60%were initially suspected of malignancy(metastatic lymphadenopathy and lymphoma).The clinical manifestations were nonspecific,such as fever and weight loss,without overt abdominal malaise.Many patients showed high concentrations of serum C-reactive protein,erythrocyte sedimentation rate,alkaline phosphatase,γ-glutamyl transpeptidase and carbohydrate antigen 125.Peripheral rim-like enhancement was a characteristic finding on contrast-enhanced CT for all the patients.Pathological examination confirmed the diagnosis in 90%of patients with caseous granulo-matous inflammation and positive results of Xpert MTB/RIF,quantitative real-time PCR and/or metagenomic next-generation sequenc-ing assays.All patients underwent antituberculosis therapy with a median treatment duration of 13.5 months(range,1-43 months).They all showed satisfactory therapeutic responses with improved symptoms and resolution on imaging after treatment.Pathological examination by biopsy remains the primary diagnostic method.A combination of the characteristic epidemiologic,clinical,imaging fea-tures and lesion biopsy for histopathology are essential for the diagnosis and treatment of TL.展开更多
基金supported by the National key research and development program(2021YFC2301800)。
文摘Porta hepatis tuberculous lymphadenopathy(TL)is rare,and the clinical and imaging manifestations often mimic tumors.To offer a bet-ter understanding of porta hepatis TL and thus improve its diagnosis and treatment,here,we retrospectively reviewed and analyzed 10 porta hepatis TL cases between May 2017 and November 2022.In this study,porta hepatis TL occurred predominantly in women(70%),with a mean age of 43.1 years(range,16-70 years).Among the patients,60%were initially suspected of malignancy(metastatic lymphadenopathy and lymphoma).The clinical manifestations were nonspecific,such as fever and weight loss,without overt abdominal malaise.Many patients showed high concentrations of serum C-reactive protein,erythrocyte sedimentation rate,alkaline phosphatase,γ-glutamyl transpeptidase and carbohydrate antigen 125.Peripheral rim-like enhancement was a characteristic finding on contrast-enhanced CT for all the patients.Pathological examination confirmed the diagnosis in 90%of patients with caseous granulo-matous inflammation and positive results of Xpert MTB/RIF,quantitative real-time PCR and/or metagenomic next-generation sequenc-ing assays.All patients underwent antituberculosis therapy with a median treatment duration of 13.5 months(range,1-43 months).They all showed satisfactory therapeutic responses with improved symptoms and resolution on imaging after treatment.Pathological examination by biopsy remains the primary diagnostic method.A combination of the characteristic epidemiologic,clinical,imaging fea-tures and lesion biopsy for histopathology are essential for the diagnosis and treatment of TL.
