Hepatocellular Carcinoma with An Uncertain Diagnosis in A 40-Year-Old Sudanese Patient from An Untreated Diagnosis to Tuberculosis Is Treated

Author(s): Fadi M. Toum Ahmed, Mogahid Alteib Yousif Alteib, Osman Asim Babker

We report a case of 40 years old male retired farmer. Was diagnosed with portal hypertension due to prehepatic fibrosis and esophageal varices bleeding had chronic liver disease due to schistosomiasis and spontaneous bacterial peritonitis 8 years ago. presented complaints of small bowel chronic diarrhea, weight loss, progressive Shortness of breath low-grade fever complicated by an infection he had a history of jaundice and chronic anemia. Not smokers or adapted to drinking alcohol. On physical examination, the patient looked very ill and emaciated, Pale not jaundiced or cyanosed, Cervical lymph node was enlarged and small, and the Finger clipping grade 4 Features of Chronic liver disease. On chest examination, there is bronchial breathing bilaterally at middle zones with fine end-inspiratory crepitation, Course crepitation at base bilateral and Loud S2. Scaphoid abdomen with Splenomegaly 16 cm Blow costal margin, Liver span 8 cm, No ascites, PR not done. The first report found hepatocellular cancer, and the second report revealed this persistent metastasis in our patient with chronic liver disease, which first presents on an initial ultrasound and which we then diagnose with an abdominal CT scan. The liver tissue acquired from a liver biopsy is then used to make the histological and/or bacteriological diagnosis of extrapulmonary TB, which can be very challenging to do. Sometimes, a patient's full recovery from a particular therapy is required before a clinical diagnosis can be confirmed [6]. After the patient had recovered from anti-tuberculosis treatment, histology showed granulomatous liver TB, ruling out HCC and Mets, and visual inspection reveals cervical lymph node enlargement.

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