Isolated hepatosplenic tuberculosis.

Background: Tuberculosis rarely involves the liver and spleen and when it does so, it is usually associated with disseminated disease.

Methods: We report a patient with isolated tuberculosis of the liver and spleen.

Results: A 50-year-old man presented with weakness and loss of weight for two months. CT scan of the abdomen showed multiple small hypodense lesions in the liver and spleen. Image-guided biopsy of liver lesion was inconclusive as it showed normal hepatocytes with interspersed lymphocytes. On laparotomy, the liver and spleen were studded with multiple small nodules. A 5-cm wedge of the liver was resected. Histopathological examination confirmed the diagnosis of tubercular hepatitis. A detailed work-up failed to identify any other focus of tuberculosis.

Conclusions: Although rare, tuberculosis should also be considered in the differential diagnosis for multiple nodules in the liver and spleen, along with lymphoproliferative diseases and metastatic lesions.