Chapter 27 : Tuberculosis of the Liver, Biliary Tract, and Pancreas

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Involvement of the liver in patients with has been described for nearly two centuries. One of the earliest descriptions was published in Guy’s Hospital Reports by Thomas Addison in 1836 ( ). The first recorded case of hepatic tuberculosis was reported in 1858 by John Bristowe in England ( ), and hepatic tuberculosis was classified into miliary and local forms by Rolleston and McNee in 1905 ( ). Autopsy studies during the latter half of the 19th century and early 20th century demonstrated granulomas and a variety of other lesions in the livers of patients dying with tuberculosis ( ). The reports by Gillman and Gillman ( ) and subsequently by many others ( ) on the use of needle biopsy of the liver to demonstrate tuberculous lesions have made the procedure a valuable tool for diagnosis of the disease, especially in cases of cryptic miliary tuberculosis without recognized pulmonary involvement ( ). Although isolated hepatobiliary tuberculosis was described infrequently in years past ( ), a number of detailed reviews attest to its continued importance in the clinical spectrum of the disease ( ).

Citation: McMullan G, Lewis J. 2017. Tuberculosis of the Liver, Biliary Tract, and Pancreas, p 439-482. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0025-2016
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Figure 1

Tubercle comprising Langerhans giant cells, epithelioid cells, and lymphocytes. Reprinted from reference , with permission.

Citation: McMullan G, Lewis J. 2017. Tuberculosis of the Liver, Biliary Tract, and Pancreas, p 439-482. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0025-2016
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Image of Figure 2
Figure 2

Low-magnification hematoxylin-and-eosin-stained hepatic granuloma with giant cells. © University of Alabama at Birmingham, Department of Pathology for the PIER images.

Citation: McMullan G, Lewis J. 2017. Tuberculosis of the Liver, Biliary Tract, and Pancreas, p 439-482. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0025-2016
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Image of Figure 3
Figure 3

Hypodense 13.0- by 8.0- by 7.0-cm hepatic tuberculoma with calcification. Reprinted from reference , with permission.

Citation: McMullan G, Lewis J. 2017. Tuberculosis of the Liver, Biliary Tract, and Pancreas, p 439-482. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0025-2016
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Image of Figure 4
Figure 4

Miliary tuberculosis of the liver. © University of Alabama at Birmingham, Department of Pathology for the PIER images.

Citation: McMullan G, Lewis J. 2017. Tuberculosis of the Liver, Biliary Tract, and Pancreas, p 439-482. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0025-2016
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