Ultrasound findings in hepatic mycobacterial infections in patients with acquired immune deficiency syndrome (AIDS).

Ultrasound findings in 12 AIDS patients with abdominal mycobacterial infections were reviewed and correlated with liver histology. Liver ultrasound abnormalities were common--present in 4/5 patients with Mycobacterium avium-intracellulare (MAI) and 7/7 patients with Mycobacterium tuberculosis (MTB) infection. The commonest ultrasound abnormality of the liver was a generally 'bright' liver, seen in 7/12 patients. Focal liver lesions were seen in 5/7 patients with MTB but were not seen in any patients with MAI infection. Both hyperechoic (two patients) and hypoechoic (three patients) lesions were seen. Lymphadenopathy as demonstrated on abdominal ultrasound was a relatively infrequent finding--only seen in three patients with MTB, all of whom also had focal liver lesions. On histology, 8/12 patients showed fatty infiltration and 8/12 showed granuloma. Abnormalities are commonly seen on ultrasound examination of the liver in AIDS patients with abdominal mycobacterial infections but are non-specific and ultrasound guided biopsy is indicated to confirm the diagnosis and exclude other disease.