Tuberculous common bile duct stricture mimicking a cholangiocarcinoma: A case report

Abstract

Biliary involvement during abdominal tuberculosis is extremely uncommon and represents a challenging diagnosis that can easily be mistaken for a malignant etiology. We report the case of a 40 years old male who presented with anorexia, chronic abdominal pain, and progressive obstructive jaundice. Abdominal computed tomography demonstrated distal narrowing with wall thickening of the main biliary duct, along with enlarged lymph nodes and signs of portal hypertension. Abdominal magnetic resonance imaging showed a long distal biliary stricture, suggestive of malignancy, with dilated intrahepatic radicles. The diagnosis of cholangiocarcinoma was initially suggested. However, given his young age and other imaging findings, the patient underwent laparoscopic biopsy which revealed epithelioid cell granuloma with caseating necrosis consistent with tuberculous origin.

Hilar tuberculosis versus Klatskin tumour: a diagnostic challenge

“…An interesting article by Adil et al reported a similar case of TB mimicking cholangiocarcinoma, however, it was the presence of multiple lymph nodes that favoured the diagnosis of TB in the patient 11. The absence of lymph nodes though not typical of TB does not rule it out.…”

CircSETD3 (hsa_circ_0000567) inhibits proliferation and induces apoptosis in cholangiocarcinoma cells via downregulation of microRNA-421 expression

“…Cholangiocarcinoma (CCA) is a malignant tumor originating from the extrahepatic bile duct, including the bile duct from the hilar region to the lower end of the common bile duct [ 1 , 2 ]. Most patients with CCA have jaundice, weight loss, abdominal pain, sometimes accompanied by fever, abdominal mass, and other symptoms [ 3 ].…”