Liver Paradoxical Reaction Presenting as a Solitary Hepatic Mass during Antituberculosis Therapy
Abstract
A vegan Indian woman in her late 20s was diagnosed with pulmonary tuberculosis. Imaging revealed a solitary hepatic mass five months after the initiation of antituberculosis therapy. Contrast-enhanced ultrasonography cannot distinguish between inflammation and malignancy. A biopsy revealed epithelioid cell granulomas without caseous necrosis, while a smear, culture, and PCR were negative. The therapy was continued without modification, and the hepatic lesion regressed within 7 months, consistent with a hepatic paradoxical reaction. This case illustrates that a new solitary hepatic mass emerging during antituberculosis therapy may represent a paradoxical reaction, and recognition of this entity may help clinicians avoid unnecessary regimen changes and invasive interventions, such as surgical resection.
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BibTeX
@article{takada2026liver,
title = {{Liver Paradoxical Reaction Presenting as a Solitary Hepatic Mass during Antituberculosis Therapy}},
author = {Yohei Takada and Takashi Inao and Ayumi Akamatsu and Kazuya Monden and Kojiro Otsuka and Kozo Ikuta and Chiho Ohbayashi and Riyo Fujiyama and Nobuya Kusunoki and Daiki Masuya and Yujiro Suzuki},
journal = {Internal Medicine},
year = {2026},
month = nov,
doi = {10.2169/internalmedicine.6629-25},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/65/21/65_6629-25/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Liver Paradoxical Reaction Presenting as a Solitary Hepatic Mass during Antituberculosis Therapy
AU - Yohei Takada
AU - Takashi Inao
AU - Ayumi Akamatsu
AU - Kazuya Monden
AU - Kojiro Otsuka
AU - Kozo Ikuta
AU - Chiho Ohbayashi
AU - Riyo Fujiyama
AU - Nobuya Kusunoki
AU - Daiki Masuya
AU - Yujiro Suzuki
PY - 2026
DA - 2026/11/01
JO - Internal Medicine
DO - 10.2169/internalmedicine.6629-25
UR - https://www.jstage.jst.go.jp/article/internalmedicine/65/21/65_6629-25/_article
AB - A vegan Indian woman in her late 20s was diagnosed with pulmonary tuberculosis. Imaging revealed a solitary hepatic mass five months after the initiation of antituberculosis therapy. Contrast-enhanced ultrasonography cannot distinguish between inflammation and malignancy. A biopsy revealed epithelioid cell granulomas without caseous necrosis, while a smear, culture, and PCR were negative. The therapy was continued without modification, and the hepatic lesion regressed within 7 months, consistent with a hepatic paradoxical reaction. This case illustrates that a new solitary hepatic mass emerging during antituberculosis therapy may represent a paradoxical reaction, and recognition of this entity may help clinicians avoid unnecessary regimen changes and invasive interventions, such as surgical resection.
SN - 1349-7235
SN - 0918-2918
ER -