Porta Hepatis Tuberculous Lymphadenopathy: Clinical and Imaging Features of 10 Cases  

作　　者：Wenjuan Hu Ming Hu Jiafeng Xia Shengyue Chen Xiaomeng Li Chengmin Sheng Wanru Guo Xuewen Feng Yanwan Shangguan Bin Lu Yunzhen Shi Junke Qiu Kaijin Xu 

机构地区：[1]State Key Laboratory for Diagnosis and Treatment of Infectious Diseases,National Clinical Research Center for Infectious Diseases,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases,The First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou,China [2]Department of Cardiology,the Second Affiliated Hospital of Dalian Medical University,Dalian,China [3]Department of Infectious Diseases,Affiliated Dongyang Hospital of Wenzhou Medical University,Dongyang,China [4]Department of Tuberculosis Intensive Care Unit,Hangzhou Red Cross Hospital,Hangzhou,China

出　　处：《Infectious Microbes & Diseases》2024年第1期29-35,共7页感染微生物与疾病（英文）

基　　金：supported by the National key research and development program(2021YFC2301800)。

摘　　要：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.

关 键 词：porta hepatis tuberculous lymphadenopathy MISDIAGNOSIS tumor mimicking 

分 类 号：R551.2[医药卫生—血液循环系统疾病]