Mycobacterium tuberculosis
Joseph Misdraji, MD
Key Facts
Clinical Issues
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In primary TB, liver is usually involved as part of disseminated TB
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Reactivation TB can involve liver along with lungs or liver alone
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Evidence of pulmonary TB in 65-78% of patients
Microscopic Pathology
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Numerous granulomas with or without central necrosis
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Coalescence of granulomas can produce tuberculoma
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Immunocompromised patients have poorly developed granulomas or abscesses
Ancillary Tests
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Acid-fast stains positive in 60% of cases
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Culture is more likely to be positive in cases with caseating necrosis
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PCR has 53-88% sensitivity and 96-100% specificity
Paraffin section of the liver from an autopsy of a patient who died of miliary TB shows multiple necrotizing granulomas  . |
High-power view of hepatic miliary tuberculosis shows a granuloma with focal eosinophilic granular necrotic material  and several multinucleated giant cells  . |
TERMINOLOGY
Abbreviations
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Mycobacterium tuberculosis (MTB)
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Tuberculosis (TB)
Definitions
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Infection by M. tuberculosis
ETIOLOGY/PATHOGENESIS
Infectious Agents
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