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1
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Dixit S, Verma AK, Bajpai J, Kant S, Jaiswal R, Singh A. Uncommon presentation of gastrointestinal tuberculosis-A case series. Indian J Tuberc 2025; 72:133-138. [PMID: 39890363 DOI: 10.1016/j.ijtb.2024.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 06/21/2024] [Accepted: 06/24/2024] [Indexed: 02/03/2025]
Abstract
Tuberculosis (TB) is a common disease in underdeveloped countries. Of all tuberculosis cases worldwide, 28% were reported from India. The most prevalent site of infection is the lungs (pulmonary TB), whereas extrapulmonary tuberculosis (EPTB) is less common. The most common form of EPTB in India is Lymph Node TB, which accounts for around 35% of total EPTB cases. Splenic tuberculosis incidence is 8 % whereas tuberculosis of pancreas and gall bladder is extremely rare. Pancreatic and gallbladder tuberculosis (GT) is extremely rare and presents with non-specific features. The clinical manifestations of EPTB are variable, imitate other diseases, and are usually confused with other diseases. Thus, it is crucial to be cautious and highly suspicious of EPTB infection in endemic areas. Probability of developing EPTB in immunocompromised patients is higher than in immunocompetent patients. The burden of EPTB in HIV patients ranges from 15 to 20% of all TB cases in HIV-negative patients, while in HIV-positive people, it accounts for around 40-50% of new TB cases. Histopathological examination (HPE) and positive Acid-Fast Bacilli (AFB) smears are used to make the diagnosis. ATT is given to such patients for 6 months. Due to such a diverse presentation of TB, here, we report a case series of extrapulmonary TB occurring in the abdomen in, pancreas, gallbladder, and spleen.
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Affiliation(s)
- Sapna Dixit
- Department of Respiratory Medicine, King George's Medical University, Lucknow, India
| | - Ajay Kumar Verma
- Department of Respiratory Medicine, King George's Medical University, Lucknow, India
| | - Jyoti Bajpai
- Department of Respiratory Medicine, King George's Medical University, Lucknow, India.
| | - Surya Kant
- Department of Respiratory Medicine, King George's Medical University, Lucknow, India
| | - Riddhi Jaiswal
- Department of Pathology, King George's Medical University, Lucknow, India
| | - Anjali Singh
- Department of Respiratory Medicine, King George's Medical University, Lucknow, India
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2
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Dhali A, Maity R, Biswas J, Mukherjee S, Dhali GK. Gallbladder tuberculosis mimicking carcinoma: A case report of a rare entity. Int J Surg Case Rep 2024; 123:110228. [PMID: 39226636 PMCID: PMC11780384 DOI: 10.1016/j.ijscr.2024.110228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Revised: 08/22/2024] [Accepted: 08/29/2024] [Indexed: 09/05/2024] Open
Abstract
INTRODUCTION Gallbladder TB (GBTB) is a rare disease with a non-specific presentation, simulating cholecystitis and gallbladder malignancies. We describe a rare case of infiltrative GBTB with biliary strictures in a young female who was initially diagnosed with metastatic gallbladder carcinoma. CASE PRESENTATION A 33-year-old female presented with recurrent episodes of obstructive jaundice, significant weight loss, fatigue, and oligomenorrhoea. Imaging studies revealed features of locally advanced gallbladder carcinoma with proximal and distal common bile duct strictures. However, biopsy of the liver tissue surrounding the gallbladder mass confirmed necrotizing granulomatous inflammation with similar findings from fine needle aspiration of the cervical lymph node. Along with the histopathological findings, radiological evidence of pulmonary tuberculosis confirmed the diagnosis of infiltrative GBTB. The patient was successfully managed with anti-tubercular drugs along with biliary decompression. DISCUSSION The rarity of GBTB is attributed to the high alkalinity of bile and bile acids, which afford protection against tubercle bacilli. Patients commonly present with abdominal pain, fever, abdominal lump, anorexia, and weight loss. Biliary strictures, though rare, have been described in GBTB and simulate cholangiocarcinoma. Due to the non-specific findings of pre-operative laboratory and radiological investigations, most patients are taken up for surgery and diagnosed with TB on post-operative histological analysis. CONCLUSION Gallbladder TB is a rare disease which poses a diagnostic challenge because it lacks any pathognomonic features. A tissue diagnosis must be carried out before confirming gallbladder and biliary tract malignancies. Physicians in TB-endemic regions should possess a high index of suspicion for diagnosing GBTB.
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Affiliation(s)
- Arkadeep Dhali
- Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India; Academic Department of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, United Kingdom; School of Medicine and Population Health, University of Sheffield, United Kingdom.
| | - Rick Maity
- Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | | | - Souradip Mukherjee
- Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.
| | - Gopal Krishna Dhali
- Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
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3
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Soni S, Sreesanth KS, Varshney V, Swami A. Gall bladder tuberculosis: Review of literature. Indian J Tuberc 2022; 69:421-426. [PMID: 36460370 DOI: 10.1016/j.ijtb.2021.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/13/2021] [Accepted: 08/23/2021] [Indexed: 06/17/2023]
Abstract
Gall bladder tuberculosis (GB TB) is a very rare disease and scarce data is available on exact incidence and clinicopathogenesis even in endemic areas. The aim is to provide an insight into epidemiology, pathophysiology and management for better understanding of gall bladder tuberculosis. We collected data available from the literature on all histologically proven gall bladder tuberculosis. Case reports with either no article or only abstracts were available excluded from the study. Fifty two case reports and series with total 73 patients were included in this study. Mean age of patients was 48 years (Range 8-86 years) with male: female ratio of 1:1.7. 53 (73%) patient had isolated disease and 18 (24%) had associated abdominal tuberculosis. 3 (4%) of patients had concomitant and 7 (9%) had past history of pulmonary tuberculosis. 39 patients presented as cholecystitis and 25 as gall bladder mass. 44 (60%) patients had gall stones and majority of them (56%) are multiple. Granuloma and caseous necrosis was found in 80% & 60% of patients respectively. In conclusion, Gall bladder tuberculosis is a very uncommon presentation of abdominal tuberculosis. Pre-operative diagnosis is not possible due to lack of specific diagnostic test so increase in awareness and a high index of suspicious is required.
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Affiliation(s)
- Subhash Soni
- Department of Surgical Gastroenterology, AIIMS Jodhpur, Rajasthan, India.
| | - K S Sreesanth
- Department of Surgical Gastroenterology, AIIMS Jodhpur, Rajasthan, India
| | - Vaibhav Varshney
- Department of Surgical Gastroenterology, AIIMS Jodhpur, Rajasthan, India
| | - Ashish Swami
- Department of Surgical Gastroenterology, AIIMS Jodhpur, Rajasthan, India
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4
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Siddiqui ATS, Parkash O. Infiltrative gallbladder tuberculosis versus locally infiltrating tumour of the gallbladder: a diagnostic dilemma unmasked by histopathology. BMJ Case Rep 2021; 14:14/6/e241178. [PMID: 34162605 DOI: 10.1136/bcr-2020-241178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Gallbladder tuberculosis (TB) as an isolated infection and is an extremely rare entity even in parts of the world with endemicity. Though it has myriad ways of presentation, it can be cured successfully. We present a case of a 53-year-old man who presented with epigastric fullness and bloating with on and off low-grade fever for 2 months and significant weight loss. He underwent a CT scan, which showed a soft tissue gallbladder mass causing mural thickening of the antrum and lesser curvature. This was followed by a CT-guided core biopsy and gastric antrum biopsy via gastroscopy. Histopathology revealed chronic granulomatous inflammation in both samples. Various clinical presentations of gallbladder TB have been reported in literature, but to the best of our knowledge, the present case has a unique presentation and has never been reported before.
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Affiliation(s)
| | - Om Parkash
- Department of Medicine, Aga Khan University, Karachi, Pakistan
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5
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Ramdani A, Rockson O, Bouhout T, Serji B, El Harroudi T. Gallbladder Tuberculosis Mimicking Gallbladder Carcinoma: A Case Report and Review of the Literature. Cureus 2020; 12:e7950. [PMID: 32509476 PMCID: PMC7271036 DOI: 10.7759/cureus.7950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Gallbladder tuberculosis (GT) is an extremely rare disease entity, even in our country Morocco known for being an endemic area. The lack of pathognomonic clinical presentation and radiological features of GT makes preoperative diagnosis unlikely and poses a diagnostic dilemma regarding gallbladder carcinoma (GC). The diagnosis is usually made by histological examination after cholecystectomy, highlighting the importance of sending every gallbladder specimen to pathology. We report an exceedingly rare case of GT mimicking GC and refer to a recent review of the literature to discuss the clinical and radiological features of GT.
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Affiliation(s)
- Abdelbassir Ramdani
- Surgical Oncology, Mohammed VI University Hospital, Regional Oncology Center, Oujda, MAR
| | - Obed Rockson
- Surgical Oncology, Mohammed VI University Hospital, Regional Oncology Center, Oujda, MAR
| | - Tariq Bouhout
- Surgical Oncology, Mohammed VI University Hospital, Regional Oncology Center, Oujda, MAR
| | - Badr Serji
- Surgical Oncology, Mohammed VI University Hospital, Regional Oncology Center, Oujda, MAR
| | - Tijani El Harroudi
- Surgical Oncology, Mohammed VI University Hospital, Regional Oncology Center, Oujda, MAR
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6
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Chan KS, Shelat VG, Tan CH, Tang YL, Junnarkar SP. Isolated gallbladder tuberculosis mimicking acute cholecystitis: A case report. World J Gastrointest Surg 2020; 12:123-128. [PMID: 32218895 PMCID: PMC7061240 DOI: 10.4240/wjgs.v12.i3.123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/20/2019] [Accepted: 12/14/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Isolated tuberculosis of the gallbladder is extremely rare due to its intrinsic resistance to tuberculous infections. There are reports of gallbladder tuberculosis mimicking cholecystitis or malignancy. However, these presentations were chronic. The diagnosis of gallbladder tuberculosis warrants the need for investigation of additional sites of inoculation and contact tracing of all tuberculosis contacts. Gallbladder tuberculosis is a rare entity but should be suspected in patients from endemic regions with risk factors such as underlying immunosuppression or history of tuberculosis. CASE SUMMARY We present a case of gallbladder tuberculosis presenting as acute cholecystitis. A 44-year-old Filipino lady presented with a 11-d history of right hypochondrium and epigastric pain which worsened after meals with no significant past medical history. She underwent laparoscopic cholecystectomy on the presumptive diagnosis of acute cholecystitis and diagnosed as gallbladder tuberculosis after histopathological examination. The patient did not have features of pulmonary or systemic tuberculosis nor was she immunocompromised. She recovered uneventfully. She was subsequently discharged and followed-up at a hospital in her home country due to financial and social reasons. CONCLUSION Clinicians should have a high index of suspicion for patients in endemic regions presenting with cholecystitis.
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Affiliation(s)
- Kai Siang Chan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
| | - Vishal G Shelat
- Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Cher Heng Tan
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | | | - Sameer P Junnarkar
- Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore
- Department of Pathology, Tan Tock Seng Hospital, Singapore 308433, Singapore
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7
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Chaudhary D, Kaur N, Mandal S, Khurana N, Singh CB. Incidentally detected acalculous tubercular cholecystitis: A rare case report with a comprehensive review of literature. INDIAN J PATHOL MICR 2019; 62:627-628. [PMID: 31611458 DOI: 10.4103/ijpm.ijpm_107_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Dimple Chaudhary
- Department of Pathology and Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
| | - Navpreet Kaur
- Department of Pathology and Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
| | - Shramana Mandal
- Department of Pathology and Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
| | - Nita Khurana
- Department of Pathology and Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
| | - C B Singh
- Department of Pathology and Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
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8
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Agarwal A, Kumar R, Goyal A, Bagarhatta M. Tuberculosis of the gallbladder-another one of its many faces. Indian J Tuberc 2019; 67:257-259. [PMID: 32553321 DOI: 10.1016/j.ijtb.2019.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 08/16/2019] [Indexed: 11/17/2022]
Abstract
Abdominal tuberculosis is not uncommon in developing countries which usually presents as involvement of ileo-caecal junction. Involvement of gall bladder by tuberculosis is rare and thus, imaging diagnosis is unlikely. The diagnosis is confirmed only on histopathology. We present a case of a middle-aged Indian female with tuberculosis of gall bladder who was diagnosed after image guided biopsy and was managed with anti-tubercular treatment.
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Affiliation(s)
- Aakanksha Agarwal
- Department of Radiodiagnosis and Modern Imaging, SMS Medical College, Jaipur, Rajasthan, India.
| | - Raghav Kumar
- Department of Radiodiagnosis and Modern Imaging, SMS Medical College, Jaipur, Rajasthan, India
| | - Alka Goyal
- Department of Radiodiagnosis and Modern Imaging, SMS Medical College, Jaipur, Rajasthan, India
| | - Meenu Bagarhatta
- Department of Radiodiagnosis and Modern Imaging, SMS Medical College, Jaipur, Rajasthan, India
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9
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Abstract
Tuberculosis (TC) is very common and significant cause of morbidity and mortality worldwide. Isolated cystic duct lymph node TC cases without involvement of gallbladder are exceedingly rare. It is difficult to diagnose preoperatively because of lack of characteristic signs and symptoms of TC. We report a man aged 45 years who presented with right upper abdominal pain since 1week. It was associated with nausea and postprandial fullness. There was no evidence of jaundice and lymphadenopathy. Abdominal examination showed moderate right upper quadrant tenderness with positive Murphy's sign and splenomegaly but no signs of peritonism. Abdomen ultrasound revealed sludge in gallbladder, dilated pancreatic duct, coarse exotexture of liver, splenomegaly and no lymphadenopathy. He underwent laparoscopic cholecystectomy; histological report showed chronic caseating granulomatous lymphadenitis with Langhans type of giant cells in lymph node near cystic duct with chronic cholecystitis of gallbladder. Standard antituberculosis therapy was given for 12 months.
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Affiliation(s)
- Aamir Ghazanfar
- Department of General Surgery, KRL Hospital, Islamabad, Pakistan
| | - Afifa Asghar
- Department of General Surgery, KRL Hospital, Islamabad, Pakistan
| | | | - Iram Hassan
- Department of General Surgery, KRL Hospital, Islamabad, Pakistan
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10
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Gallbladder Tuberculosis Mimicking Gallbladder Carcinoma: A Case Report and Literature Review. Case Reports Hepatol 2016; 2016:3629708. [PMID: 27200195 PMCID: PMC4856939 DOI: 10.1155/2016/3629708] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 03/22/2016] [Accepted: 04/06/2016] [Indexed: 12/29/2022] Open
Abstract
Gallbladder tuberculosis (GT) is extremely rare, and it is difficult to differentiate from other gallbladder diseases, such as gallbladder carcinoma and Xanthogranulomatous Cholecystitis. A correct preoperative diagnosis of GT is difficult. The final diagnosis is usually made postoperatively according to surgical biopsy. Here, we report a case of a patient who underwent surgery with the preoperative diagnosis of gallbladder carcinoma. We reviewed the literature and present the process of differential diagnosis between two or more conditions that share similar signs or symptoms.
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11
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Shekhar C, Bhatt SK, Shuiab M, Ansari IM. WITHDRAWN: Gallbladder tuberculosis mimicking carcinoma gallbladder: A case report. Int J Surg Case Rep 2015. [DOI: 10.1016/j.ijscr.2014.12.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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12
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[Tuberculosis of the gallbladder vs metastatic vesicular carcinoma; a diagnostic dilemma]. Cir Esp 2014; 93:e143-5. [PMID: 24889050 DOI: 10.1016/j.ciresp.2014.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 04/20/2014] [Accepted: 04/22/2014] [Indexed: 11/23/2022]
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13
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Ryu MJ, Jeon TJ, Park JY, Choi Y, Baek SS, Sinn DH, Oh TH, Kim JY. [A case of gallbladder tuberculosis diagnosed by positive tuberculosis-polymerase chain reaction]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2014; 63:51-5. [PMID: 24463290 DOI: 10.4166/kjg.2014.63.1.51] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Gallbladder tuberculosis is an extremely rare disease that is rarely reported in the literature. Arriving at the correct diagnosis of gallbladder tuberculosis is difficult, and it is usually made by histopathologic examination after cholecystectomy. However, due to the low sensitivity of acid-fast stain and culture result, diagnosing gallbladder tuberculosis is still demanding even after tissue acquisition. To overcome this problem, tuberculosis-polymerase chain reaction (TB-PCR) is performed on the resected specimen, which has high sensitivity and specificity. A 70-year-old female who had previously undergone total gastrectomy for advanced gastric cancer was admitted with right upper quadrant pain. Abdominal ultrasonography and computed tomography revealed acute cholecystitis without gallstones or sludge. She underwent cholecystectomy and the histopathologic finding of the specimen showed chronic active cholecystitis without gallstones or sludge. Because she was suspected to have pulmonary tuberculosis, TB-PCR was also performed on the resected gallbladder. TB-PCR showed positive reaction for Mycobacterium tuberculosis and we could diagnose it as gallbladder tuberculosis. Herein, we present a case of gallbladder tuberculosis diagnosed by TB-PCR from resected gallbladder.
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Affiliation(s)
- Mi Jin Ryu
- Division of Gastroenterology, Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul 139-707, Korea
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14
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Mycobacterial infection of the gallbladder masquerading as gallbladder cancer with a false positive pet scan. Case Rep Med 2013; 2013:828631. [PMID: 23573099 PMCID: PMC3613049 DOI: 10.1155/2013/828631] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 02/07/2013] [Indexed: 01/19/2023] Open
Abstract
Isolated mycobacterial infection of gall bladder is an extremely rare entity. Only anecdotal reports are evident in the literature. A preoperative diagnosis of mycobacterial infection of gallbladder is therefore very difficult. The case of a 72-year-old male who underwent surgery for suspected gallbladder cancer is presented. The diagnosis of cancer was based on radiological findings and an abnormal uptake of fluorine-18-fluoro-2-deoxy-D-glucose (FDG) on positron emission tomography (PET) scan whilst being followed up for colorectal cancer. He underwent cholecystectomy and gallbladder bed resection. Histopathology was consistent with mycobacterial infection of the gallbladder.
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15
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Koui BS, Keita M, Kouyate M, Gowe EE, Aman NA, Kone S, Koffi KD, Honde M. Tuberculose de la vésicule biliaire: à propos d’un cas et revue de la littérature. JOURNAL AFRICAIN D'HÉPATO-GASTROENTÉROLOGIE 2012; 6:65-67. [DOI: 10.1007/s12157-011-0352-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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16
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Rozmanić V, Kilvain S, Ahel V, Banac S, Gazdik M. Pulmonary tuberculosis with gallbladder involvement: a review and case report. Pediatr Int 2001; 43:511-3. [PMID: 11737716 DOI: 10.1046/j.1442-200x.2001.01435.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- V Rozmanić
- Pediatric Clinic, University of Rijeka, Faculty of Medicine Rijeka, Children's Hospital Kantrida, Rijeka, Croatia.
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17
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Prasad A, Pandey KK. Tuberculous biliary strictures: uncommon cause of obstructive jaundice. AUSTRALASIAN RADIOLOGY 2001; 45:365-8. [PMID: 11531768 DOI: 10.1046/j.1440-1673.2001.00940.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Tuberculous biliary stricture is a very rare cause of obstructive jaundice. A case of a man who had had pulmonary tuberculosis 20 years ago is reported. He now presented with obstructive jaundice due to multiple strictures just below the confluence of the hepatic ducts and in the right hepatic duct. At surgery these turned out to be tuberculous in origin. There was also tuberculous involvement of the gall bladder and cystic duct. The commonest differential diagnosis in such cases is cholangiocarcinoma (as in the present case). Imaging helps in defining the extent of bile duct obstruction. Suspicion of the disease and establishing a tissue diagnosis is very important in treating this potentially curable condition, especially with the worldwide resurgence of tuberculosis.
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Affiliation(s)
- A Prasad
- Medicare Diagnostic Centre, Yusuf Sarai, New Delhi 110016, India.
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18
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Jain R, Sawhney S, Bhargava D, Berry M. Gallbladder tuberculosis: sonographic appearance. JOURNAL OF CLINICAL ULTRASOUND : JCU 1995; 23:327-329. [PMID: 7642774 DOI: 10.1002/jcu.1870230511] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Affiliation(s)
- R Jain
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi
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19
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Ben RJ, Young T, Lee HS. Hepatobiliary tuberculosis presenting as a gall bladder tumor. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES 1995; 27:415-7. [PMID: 8658083 DOI: 10.3109/00365549509032744] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
A 64-year-old married female was admitted with a presentation of anorexia, easy fatiguability, skin discoloration, tea-colored urine and weight loss of 1 month's duration. After a series of clinical and laboratory examinations including radiological image studies, a diagnosis of gall bladder tumor was presumed. A final diagnosis of tuberculosis of the liver and gall bladder was established by histopathological examination of tissue specimens obtained during exploratory laparotomy. Hepatobiliary tuberculosis presenting as a gall bladder tumor is rare and no pathognomonic diagnostic characteristics can be relied upon. It is necessary to confirm the diagnosis by histopathology, polymerase chain reaction (PCR), or microbiological studies on biopsy specimens in order to make possible appropriate, early therapy.
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Affiliation(s)
- R J Ben
- Department of Medicine, 802 Army General Hospital, Kaohsiung, Taiwan, Republic of China
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20
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Nakajo S, Yamamoto M, Urushihara T, Kajitani T, Tahara E. Diffuse papillomatosis of the gallbladder complicated with tuberculosis. ACTA PATHOLOGICA JAPONICA 1988; 38:1473-80. [PMID: 3223281 DOI: 10.1111/j.1440-1827.1988.tb01089.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A rare case of diffuse papillomatosis of the gallbladder complicated with tuberculosis is reported. The mucosa of the gallbladder displayed a diffuse papillary pattern composed of excrescences that varied in size and height. The proliferative glands contained many Paneth cells, and the diffuse papillomatosis appeared to be derived from metaplastic-type epithelium. Tuberculous granulomas were observed in the serous layer of the gallbladder. The relationship between diffuse papillomatosis and tuberculosis of the gallbladder is discussed.
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Affiliation(s)
- S Nakajo
- Department of Pathology, Hiroshima University School of Medicine, Japan
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