Abstract

A twenty-three year-old male patient admitted with complaints of malaise, anorexia, weight loss during a one-year period and complaints of cough and purulent sputum during the last few months. Since posteroanterior and lateral chest-X rays of the patient revealed an elevated right hemidiaphragm, thoracic and liver computed tomographic examinations were performed showing an abscess cavity in the liver. During bronchoscopy, right middle lobe bronchus as well as lower lobe medial segment bronchus were seen as narrowed. The cytological examination of the bronchial lavage fluid revealed an inflammatory exudate; while the pathological examination of the biopsy specimen suggested acute suppurative bronchitis. While the investigations for a pyogenic or amebic abscess were carried on, the patient was referred to the department of Thoracic Surgery due to hemoptysis. The subphrenic region was drained during surgery. A hard fluctuating mass which extends beyond the subphrenic area into the liver was resected as much as possible. The specimen taken from the subphrenic area showed a granulomatous inflammation with caseation necrosis on histopathological examination. The patient is reported as an interesting case of tuberculosis presenting with a liver abscess.