PMC5586922_01
a Contrast-enhanced CT scan of the abdomen in the arterial phase at the corresponding section revealing no comparable lesion. b PET scan showing abnormal diffuse hypermetabolic activity in the liver (arrow), especially in the junction of left and right liver. c PET/CT scan showing more hypermetabolic activity with more bright yellow colour (arrow).
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F1
A contrast-enhanced CT scan of the abdomen revealed calcifications in the posterior segment of the right liver and lymph node enlargement in the hepatic portal, intraperitoneal and retroperitoneal regions (fig. 1a). Abnormal diffuse hypermetabolic activity in the liver was observed, especially in the junction of the left and right liver, with maximum FDG standard uptake values of 8.81 and 12.47 at the delayed scan (180 min after the injection) (fig. 1), and a nodular hypermetabolic lesion was found in segments V and VI.
Histological examination of the liver showing a TB follicle with central caseous necrosis surrounded by lymphocytes, multinucleate giant cells and epithelioid macrophages. a HES. x40. b AFB. x100. Acid-fast staining showed several positive bacilli. One of the acid-fast bacilli is marked by the arrow.
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F2
TB follicle with central caseous necrosis surrounded by lymphocytes, multinucleate giant cells and epithelioid macrophages, revealing several acid-fast bacteria (fig. 2).