Indian Journal of Pathology and Oncology


An autopsy study of pathology of liver in tuberculosis


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Author Details: Kavita Leeladhar Khedekar, Sangita Ramulu Margam, Nitin Maheshwar Gadgil, Gourav Sakhare

Volume : 4

Issue : 1

Online ISSN : 2394-6792

Print ISSN : 2394-6784

Article First Page : 56

Article End Page : 62


Abstract

Background: Hepatic tuberculosis (TB) is an uncommon manifestation of tuberculosis. The term hepatobiliary TB refers to either isolated hepatic or hepatobiliary involvement with other organ involvement.
Methods: A five year autopsy study conducted of 236 adult cases of tuberculosis. Clinical details of all cases were obtained from hospital records. Sections from the liver were processed routinely and histopathological findings along with Clinical & biochemical findings were analysed in detail.
Results: Commonest age group affected was 31 to 40 years of age with a male: female ratio of 1.29:1. Fever was present in (56.6%). Hepatomegaly along with abdominal pain was significantly associated with Hepatic involvement by TB. Pulmonary and extra pulmonary tuberculosis was seen in 177 and 59 cases respectively. Liver involvement was mainly secondary except in one case. The spectrum of histopathological changes of the liver showed epitheliod cell granulomas in (41.5%), fatty changes in (46.6%), inflammation in (16.5%) and fibrosis in (3.8%) cases. On comparing the liver TB and non-liver TB cases, it was found that fatty changes were more common but there was no difference in the degree of fibrosis in the two groups. Comparing liver function tests, available in 213/236 cases, 61% were abnormal. Deranged AST (65%), ALT (62.05%) & ALP (57. 05%) was seen in hepatic TB cases.
Conclusion: Liver involvement was mainly in the form of secondary tuberculosis. Fever, hepatomegaly, abdominal pain, fatty change and caseating granulomas along with deranged liver enzymes are significantly associated with hepatic involvement in cases of tuberculosis.

Keywords:
Autopsy, Liver, Tuberculosis, Fatty change, Hepatomegaly, Alkaline phosphatase