TB is a growing problem worldwide; consequently, it is vital to recognize the more unusual presentations of this disease. Intra-abdominal TB has a high mortality, but it is a difficult diagnosis to make, often requiring laparotomy.
Liver tuberculoma is, in particular, rare, with fewer than 100 cases reported in the literature, most of which are secondary and associated with miliary TB. This is a case of 32 year old female with caviating right upper lobe lesion with miliary mottling and hepatic tuberculomas. Mediastinal lymphnodes are also seen.