title: A case of obstructive jaundice caused by tuberculous lymphadenitis: a literature review.
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.
authors.affiliation: Department of Internal Medicine, Health Promotion Center, Yonsei University Gangnam Severance Hospital, Seoul, Korea.
authors.forename: Su Jung
authors.initials: SJ
authors.lastname: Baik
authors.affiliation: Department of Internal Medicine, Ewha Woman's University School of Medicine, Seoul, Korea.
authors.forename: Kwon
authors.initials: K
authors.lastname: Yoo
authors.affiliation: Department of Internal Medicine, Ewha Woman's University School of Medicine, Seoul, Korea.
authors.forename: Tae Hun
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Ewha Woman's University School of Medicine, Seoul, Korea.
authors.forename: Il Hwan
authors.initials: IH
authors.lastname: Moon
authors.affiliation: Department of Pathology, Ewha Woman's University School of Medicine, Seoul, Korea.
authors.forename: Min-Sun
authors.initials: MS
authors.lastname: Cho
mesh_terms: D000293:Adolescent; D000328:Adult; D001663:Bilirubin / Q000097:blood; D004381:Duodenal Ulcer / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D004932:Esophageal and Gastric Varices / Q000473:pathology; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D001663:Bilirubin
keywords: Lymphadenitis; Portal hypertension; Tuberculosis