Clin Mol Hepatol.  2014 Jun;20(2):208-213. 10.3350/cmh.2014.20.2.208.

A case of obstructive jaundice caused by tuberculous lymphadenitis: A literature review

• Baik SJ
• Yoo K
• Kim TH
• Moon IH
• Cho MS

• KMID: 1788571
• DOI: http://doi.org/10.3350/cmh.2014.20.2.208

Abstract

Obstructive jaundice caused by tuberculous lymphadenitis is a rare manifestation of tuberculosis (TB), with 15 cases having been reported in Korea. We experienced a case of obstructive jaundice caused by pericholedochal tuberculous lymphadenitis in a 30-year-old man. The patient's initial serum total bilirubin level was 21.1 mg/dL. Abdominal computed tomography revealed narrowing of the bile duct by a conglomerated soft-tissue mass involving the main portal vein. Abrupt obstruction of the common bile duct was observed on cholangiography. Pathologic analysis of a ultrasonography-guided biopsy sample revealed chronic granulomatous inflammation, and an endoscopic examination revealed esophageal varices and active duodenal ulceration, the pathology of which was chronic noncaseating granulomatous inflammation. Hepaticojejunostomy was performed and pathologic analysis of the conglomerated soft-tissue mass revealed chronic granulomatous inflammation with caseation of the lymph nodes. Tuberculous lymphadenitis should be considered in patients presenting with obstructive jaundice in an endemic area.

Keyword

Tuberculosis; Lymphadenitis; Portal hypertension

MeSH Terms

Adolescent
Adult
Bilirubin/blood
Duodenal Ulcer/pathology
Endoscopy, Gastrointestinal
Esophageal and Gastric Varices/pathology
Female
Humans
Jaundice, Obstructive/*diagnosis
Male
Middle Aged
Tomography, X-Ray Computed
Tuberculosis, Lymph Node/*diagnosis
Young Adult
Bilirubin