Sclerosing cholangitis-like changes in hepatobiliary tuberculosis.
Atypical presentations of tuberculosis might cause difficulties in diagnosis, especially in developing countries. Primary hepatobiliary tuberculosis is a rare condition and the diagnosis of this condition necessitates a high index of suspicion. In this report, we present a case with obstructive jaundice, dilated intrahepatic bile ducts and lymphadenopathies in the porta hepatis. Endoscopic retrograde cholangiopancreaticography showed irregularities, strictures and dilatations both in the intra- and extrahepatic bile ducts resembling sclerosing cholangitis. The liver biopsy showed caseous granulomatous hepatitis and Langhans giant cells compatible with tuberculosis, and a lymph node biopsy obtained from the left cervical region demonstrated caseating confluent granulomas with abundant acid-fast bacilli. The present case shows that primary hepatobiliary tuberculosis may mimic primary sclerosing cholangitis and should be considered in the differential diagnosis of patients with sclerosing cholangitis-like changes on endoscopic retrograde cholangiopancreaticography.
Department of Gastroenterology, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey. yoozderin@gmail.com
Yasemin
Y
Ozin
Erkan
E
Parlak
Zeki Mesut Yalin
ZM
Kiliç
Tülay
T
Temuçin
Nurgül
N
Saşmaz
D000328:Adult; D001660:Biliary Tract Diseases / Q000175:diagnosis*; D001706:Biopsy; D002760:Cholangiopancreatography, Endoscopic Retrograde; D015209:Cholangitis, Sclerosing / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D014386:Tuberculosis, Hepatic / Q000175:diagnosis*