Primary Hepatic Tuberculosis in an Immuno-Competent Lady Masquerading as Hepatic Neoplasm

We report a 38 year old non-diabetic, immune-competent lady who presented with fever, anorexia, weight loss and right upper quadrant abdominal pain and was found to have multiple hepatic space-occupying lesions on Contrast enhanced Computed Tomography scan of abdomen in absence of any intra-abdominal lymphadenopathy or ascites. Demonstration of epithelioid cell granulomas and culture of the aspirate confirmed its tuberculous etiology thus ruling out any neoplastic pathology. There was no evidence of pulmonary tuberculosis. Patient responded excellently to antitubercular drugs with radiological resolution of the lesions. Despite the rarity of this condition, primary hepatic tuberculosis should be considered among the differential diagnoses of space-occupying lesions of the liver.