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Kloub MN, Elfert K, Elnajjar A, Alnasarat A, Alhadidi G, Anwar A, Atiyat R. Obstructive Jaundice Secondary to Hepatic Hilar Tuberculosis Without Pulmonary Involvement. Eur J Case Rep Intern Med 2024; 11:004277. [PMID: 38352819 PMCID: PMC10860912 DOI: 10.12890/2024_004277] [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] [Received: 12/28/2023] [Accepted: 01/11/2024] [Indexed: 02/16/2024] Open
Abstract
Tuberculosis (TB) is primarily a respiratory infection with huge mortality and morbidity worldwide. Extrapulmonary TB infection is common, affecting lymph nodes, pleura, and abdomen, but the prima-ry biliary presentation without lung involvement is exceedingly rare. We report on a 38-year-old male patient presented with isolated obstructive jaundice secondary to TB infection. This case highlights the importance of considering TB infection in the differential diagnosis of obstructive jaundice, especially in the endemic area. We also provide a literature review on TB infection, mainly in the biliary tract. LEARNING POINTS Tuberculosis (TB) can affect the biliary system, mimicking cholangiocarcinoma without pulmonary involvement.Early recognition of biliary TB and treatment can prevent permanent complications and invasive intervention requirements.Using standard anti-tuberculous medications has shown high efficiency in treating and eradicating mycobacterial infection in such locations.
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Affiliation(s)
- Mohammad N. Kloub
- Department of Internal Medicine, Saint Michael’s Medical Center, Newark, USA
| | - Khalid Elfert
- Department of Internal Medicine, SBH Health System, New York, USA
| | - Ahmed Elnajjar
- Department of Internal Medicine, Gastroenterology and Hepatology, Hamad Medical Corporation, Doha, Qatar
| | - Ahmad Alnasarat
- Department of Internal Medicine, Wayne State University/Detroit Medical Center Sinai Grace, Detroit, USA
| | | | | | - Raed Atiyat
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Saint Michael’s Med-ical Center, Newark, USA
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Krishna S, Mishra AK, Ravina M, Kashyap Y, Bansal H, Dasgupta S. Primary Biliary Tuberculosis Masquerading Cholangiocarcinoma in 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography. Indian J Nucl Med 2022; 37:265-267. [PMID: 36686295 PMCID: PMC9855251 DOI: 10.4103/ijnm.ijnm_204_21] [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] [Received: 12/17/2021] [Revised: 02/13/2022] [Accepted: 02/23/2022] [Indexed: 11/05/2022] Open
Abstract
Hepatobiliary involvement is a less common manifestation of abdominal tuberculosis. We present the case of a 42-year-old female who presented with fever, abdominal pain, and jaundice of 2 months duration. 18F-fluorodeoxyglucose positron emission tomography/computed tomography done for disease evaluation suggested the likely possibility of cholangiocarcinoma but excision biopsy from periportal lymph node later confirmed a granulomatous etiology and she was successfully treated with antitubercular therapy.
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Affiliation(s)
- Sarin Krishna
- Department of Nuclear Medicine, AII India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Ajit Kumar Mishra
- Department of General Surgery, DKS Hospital, Raipur, Chhattisgarh, India
| | - Mudalsha Ravina
- Department of Nuclear Medicine, AII India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Yashwanth Kashyap
- Department of Medical Oncology, AII India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Himanshu Bansal
- Department of Nuclear Medicine, AII India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Subhajit Dasgupta
- Department of Nuclear Medicine, AII India Institute of Medical Sciences, Raipur, Chhattisgarh, India
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3
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Adil H, Semedo A, Kessab A, En-Nouali H, El Fenni J, Abdellaoui M. Tuberculous common bile duct stricture mimicking a cholangiocarcinoma: A case report. Radiol Case Rep 2021; 16:1311-1314. [PMID: 33897922 PMCID: PMC8053780 DOI: 10.1016/j.radcr.2021.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 11/15/2022] Open
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.
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Affiliation(s)
- Hajar Adil
- Radiology Department, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Arthur Semedo
- Radiology Department, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Amine Kessab
- Pathplogy Department, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Hassan En-Nouali
- Radiology Department, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Jamal El Fenni
- Radiology Department, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Mohamed Abdellaoui
- Radiology Department, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
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AL Umairi R, AL Abri A, Kamona A. Tuberculosis (TB) of the Porta Hepatis Presenting with Obstructive Jaundice Mimicking a Malignant Biliary Tumor: A Case Report and Review of the Literature. Case Rep Radiol 2018; 2018:5318197. [PMID: 30631628 PMCID: PMC6304509 DOI: 10.1155/2018/5318197] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 11/26/2018] [Indexed: 12/18/2022] Open
Abstract
Localized hepatobiliary tuberculosis (TB) is a rare disorder which can present with an obstructive jaundice mimicking other noninfectious causes such as cholangiocarcinoma. Here, we report a case of porta hepatis tuberculosis in 19-year-old female who presented with an obstructive jaundice, and her computed tomography (CT) of the abdomen revealed a hepatic hilar mass with radiological features mimicking a malignant biliary tumor. We also review the literature related to this disorder.
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Affiliation(s)
| | - Ahmed AL Abri
- Department of Radiology, The Royal Hospital, Muscat, Oman
| | - Atheel Kamona
- Department of Radiology, The Royal Hospital, Muscat, Oman
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Watanabe N, Sato R, Nagai H, Matsui H, Yamane A, Kawashima M, Suzuki J, Tashimo H, Ohshima N, Masuda K, Tamura A, Akagawa S, Hebisawa A, Ohta K. An HIV-positive Case of Obstructive Jaundice Caused by Immune Reconstitution Inflammatory Syndrome of Tuberculous Lymphadenitis Successfully Treated with Corticosteroids. Intern Med 2017; 56:2661-2666. [PMID: 28883243 PMCID: PMC5658536 DOI: 10.2169/internalmedicine.8713-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 60-year-old man was admitted to our hospital because of a persistent fever with enlargement of multiple lymph nodes in the mediastinum and around the pancreatic head. He was diagnosed with tuberculosis and human immunodeficiency virus infection. We started antiretroviral therapy three weeks after the initiation of anti-tuberculous therapy. Two weeks later, jaundice appeared with dilatation of the biliary tract due to further enlargement of the lymph nodes, which seemed to be immune reconstitution inflammatory syndrome (IRIS). The administration of corticosteroids resolved the obstructive jaundice without surgical treatment or endoscopic drainage. Obstructive jaundice caused by IRIS should first be treated with corticosteroids before invasive treatment.
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Affiliation(s)
- Naoaki Watanabe
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Japan
| | - Ryota Sato
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Japan
| | - Hideaki Nagai
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Japan
| | - Hirotoshi Matsui
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Japan
| | - Akira Yamane
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Japan
| | - Masahiro Kawashima
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Japan
| | - Junko Suzuki
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Japan
| | - Hiroyuki Tashimo
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Japan
| | - Nobuharu Ohshima
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Japan
| | - Kimihiko Masuda
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Japan
| | - Atsuhisa Tamura
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Japan
| | - Shinobu Akagawa
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Japan
| | - Akira Hebisawa
- Department of Clinical Research, National Hospital Organization Tokyo National Hospital, Japan
| | - Ken Ohta
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Japan
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Abstract
Tuberculosis of the liver, biliary tract, and pancreas is discussed. In addition, tuberculosis in the setting of HIV-AIDS and liver transplantation is explored. Drug-induced liver injury secondary to antituberculosis medication and monitoring and prophylactic treatment for such injury is also considered.
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Isolated Retropancreatic Tuberculous Lymphadenitis Mimicking Carcinoma: A Diagnostic Challenge. Case Rep Gastrointest Med 2016; 2016:7295496. [PMID: 27313915 PMCID: PMC4904085 DOI: 10.1155/2016/7295496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 05/05/2016] [Indexed: 01/22/2023] Open
Abstract
Tuberculosis as a cause of obstructive jaundice is a rare entity with only a few cases reported in the literature. Patients with this condition usually present with a protracted illness, jaundice, and weight loss, which may be confused with malignancies. We are reporting unusual case of isolated enlarged tuberculous lymph node compressing the common bile duct in the retropancreatic region and causing obstructive jaundice in an immunocompetent patient which to the best of our knowledge is the first case of isolated retropancreatic tuberculous lymphadenitis in Saudi Arabia.
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Yamada R, Inoue H, Yoshizawa N, Kitade T, Tano S, Sakuno T, Harada T, Nakamura M, Katsurahara M, Hamada Y, Tanaka K, Horiki N, Takei Y. Peripancreatic Tuberculous Lymphadenitis with Biliary Obstruction Diagnosed by Endoscopic Ultrasound-guided Fine-needle Aspiration Biopsy. Intern Med 2016; 55:919-23. [PMID: 27086805 DOI: 10.2169/internalmedicine.55.6123] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 57-year-old man with a history of tuberculosis (TB) was found to have a pancreatic head mass, accompanied by stenosis of the common bile duct. Due to the inherent difficulty in differentiating pancreatic carcinoma from an inflammatory mass, endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) was thus performed. The pathological findings confirmed granuloma with caseous necrosis, and the results of the QuantiFERON TB2G test were positive. Accordingly, the patient was diagnosed with peripancreatic TB and thereafter was successfully treated with anti-TB therapy. Based on the findings of this case, we conclude that EUS-FNAB is a useful modality for the diagnosis of pancreatic TB.
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Affiliation(s)
- Reiko Yamada
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Japan
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9
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Abdominal tuberculosis with periportal lymph node involvement mimicking pancreatic malignancy in an immunocompetent adolescent. Pediatr Radiol 2014; 44:1450-3. [PMID: 24801816 DOI: 10.1007/s00247-014-2997-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 03/10/2014] [Accepted: 04/03/2014] [Indexed: 10/25/2022]
Abstract
Abdominal tuberculosis manifesting as isolated lymphadenopathy is rare, particularly in children. Tuberculous involvement of the pancreatic head and peripancreatic area can simulate a neoplasm of the pancreatic head. To our knowledge, obstructive jaundice caused by tuberculous lymphadenopathy has not been reported in children or adolescents. Here we present radiologic findings in a case of tuberculous lymphadenopathy that mimicked malignancy of the pancreatic head and caused obstructive jaundice in an immunocompetent adolescent.
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10
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Baik SJ, Yoo K, Kim TH, Moon IH, Cho MS. A case of obstructive jaundice caused by tuberculous lymphadenitis: a literature review. Clin Mol Hepatol 2014; 20:208-13. [PMID: 25032188 PMCID: PMC4099337 DOI: 10.3350/cmh.2014.20.2.208] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 11/07/2012] [Accepted: 11/19/2012] [Indexed: 11/05/2022] Open
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.
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Affiliation(s)
- Su Jung Baik
- Department of Internal Medicine, Health Promotion Center, Yonsei University Gangnam Severance Hospital, Seoul, Korea
| | - Kwon Yoo
- Department of Internal Medicine, Ewha Woman's University School of Medicine, Seoul, Korea
| | - Tae Hun Kim
- Department of Internal Medicine, Ewha Woman's University School of Medicine, Seoul, Korea
| | - Il Hwan Moon
- Department of Internal Medicine, Ewha Woman's University School of Medicine, Seoul, Korea
| | - Min-Sun Cho
- Department of Pathology, Ewha Woman's University School of Medicine, Seoul, Korea
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A case of peripancreatic tuberculous lymphadenitis diagnosed by endoscopic ultrasound-guided fine-needle aspiration. Clin J Gastroenterol 2014; 7:68-73. [PMID: 26183512 DOI: 10.1007/s12328-013-0451-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 12/15/2013] [Indexed: 12/27/2022]
Abstract
Tuberculous lymphadenitis is a rare cause of obstructive jaundice. Here, we report the case of a 33-year-old male with obstructive jaundice caused by tuberculous lymphadenitis around the pancreatic head. The patient was born in China and had immigrated to Japan at 12 years of age. He presented with acute abdominal pain and jaundice. Findings from ultrasonography, computed tomography, and endoscopic retrograde cholangiopancreatography were suggestive of a stenosis of the distal common bile duct caused by multiple low-density masses around the pancreatic head with a contrast-enhanced solid rim. We successfully diagnosed the mass as tuberculous lymphadenitis using endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). The patient was treated with anti-tuberculous combination chemotherapy for 6 months, and subsequently exhibited clinical improvement. Thus, we found that EUS-FNA was a valuable minimally invasive method for diagnosing masses that cause icterus.
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Shen Z, Liu H. Pancreatobiliary and peripancreatobiliary tuberculosis: a rare cause of obstructive jaundice. Arch Med Sci 2013; 9:1152-7. [PMID: 24482664 PMCID: PMC3902729 DOI: 10.5114/aoms.2013.39799] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2010] [Revised: 05/13/2011] [Accepted: 07/03/2011] [Indexed: 01/26/2023] Open
Affiliation(s)
- Zhenbin Shen
- Zhongshan Hospital of Fudan University, Shanghai, China
| | - Houbao Liu
- Zhongshan Hospital of Fudan University, Shanghai, China
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13
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Ozkan F, Bulbuloglu E, Inci MF, Sayar H, Kahraman H, Yuksel M. Isolated pancreatic tuberculosis mimicking malignancy and causing obstructive jaundice. J Gastrointest Cancer 2013; 44:118-20. [PMID: 22528321 DOI: 10.1007/s12029-012-9374-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Huang CT, Lo CY, Lee TH. Isolated peripancreatic tuberculous lymphadenopathy: a rare manifestation of abdominal tuberculosis mimicking pancreatic cystic neoplasm. J Dig Dis 2013; 14:105-8. [PMID: 23121697 DOI: 10.1111/1751-2980.12011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Chung-Tsui Huang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan, China
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15
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Fernández Muinelo A, Salgado Vázquez M, Núñez Fernández S, Pardo Rojas P, Gómez Lorenzo FJ. [Obstructive jaundice secondary to liver hilar lymph node tuberculosis]. Cir Esp 2012; 91:611-2. [PMID: 22817998 DOI: 10.1016/j.ciresp.2012.04.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 02/28/2012] [Accepted: 04/30/2012] [Indexed: 11/19/2022]
Affiliation(s)
- Alejo Fernández Muinelo
- Servicio de Cirugía General y Aparato Digestivo, Complexo Hospitalario Universitario de Ourense, Ourense, España.
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Tonolini M, Bianco R. HIV-related/AIDS cholangiopathy: pictorial review with emphasis on MRCP findings and differential diagnosis. Clin Imaging 2012; 37:219-26. [PMID: 23465971 DOI: 10.1016/j.clinimag.2012.03.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 03/29/2012] [Indexed: 01/10/2023]
Abstract
Magnetic resonance cholangiopancreatography provides accurate, noninvasive diagnosis of HIV/AIDS cholangiopathy through the identification of characteristic ductal abnormalities including multiple intrahepatic strictures, papillary stenosis, and long segmental extrahepatic strictures. Endoscopic retrograde cholangiopancreatography should be reserved for cytological or bioptic investigation in doubtful cases and for operative treatment when appropriate. Furthermore, cross-sectional imaging allows differentiation from other causes of biliary dilatation in HIV-positive patients, including infectious (bacterial) cholangitis, portal biliopathy, pancreatic or duodenal lymphoma, and mycobacterial lymphadenopathies.
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Affiliation(s)
- Massimo Tonolini
- Department of Radiology, Luigi Sacco University Hospital, Via G.B. Grassi 74, 20157 Milan, Italy.
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Zhang M, Li M, Xu GP, Liu HJ. Neoplasm-like abdominal nonhematogenous disseminated tuberculous lymphadenopathy: CT evaluation of 12 cases and literature review. World J Gastroenterol 2011; 17:4038-43. [PMID: 22046094 PMCID: PMC3199564 DOI: 10.3748/wjg.v17.i35.4038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 03/11/2011] [Accepted: 03/18/2011] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess the diagnostic value of computed tomography (CT) imaging in screening for abdominal nonhematogenous disseminated tuberculous lymphadenopathy (TL).
METHODS: The CT scans of 12 patients with abdominal nonhematogenous disseminated TL suggestive of neoplasm were retrospectively analyzed in this review. The final diagnoses were confirmed by lymph node pathology for seven patients and by laparoscopic surgery for five patients. All of the patients were treated at our institution between April 1995 and August 2009.
RESULTS: The sites of involvement were the periportal (n = 6), peripancreatic (n = 3), periaortic (n = 3), and mesenteric (n = 2) regions. On the plain CT scan, the lymphadenopathy showed a heterogeneous isodensity or hypodensity in 11 patients and a low density in one patient. Peripheral enhancement was observed on the dynamic contrast-enhanced CT scans for all patients. In two cases, scans were more revealing during the portal venous and delayed phases.
CONCLUSION: Abdominal lymphadenopathy with predominant peripheral rim-like enhancement on the dynamic contrast-enhanced CT scan may suggest a diagnosis of TL.
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Tuberculous lymph node at the porta hepatis: diagnosis by EUS-guided FNA. Gastrointest Endosc 2011; 74:437-9. [PMID: 21481858 DOI: 10.1016/j.gie.2011.01.055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Accepted: 01/24/2011] [Indexed: 12/11/2022]
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Diagnosis of pancreatic tuberculosis by combined, contrast-enhanced sonography and endoscopic ultrasound-guided fine-needle aspiration. Clin J Gastroenterol 2010; 3:159-64. [DOI: 10.1007/s12328-010-0149-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Accepted: 03/16/2010] [Indexed: 02/06/2023]
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20
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Lee YJ, Jung SH, Hyun WJ, Kim SH, Lee HI, Yang HW, Kim A, Cha SW. A Case of Obstructive Jaundice Caused by Paradoxical Reaction during Antituberculous Chemotherapy for Abdominal Tuberculosis. Gut Liver 2009; 3:338-42. [PMID: 20431773 PMCID: PMC2852721 DOI: 10.5009/gnl.2009.3.4.338] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2009] [Accepted: 06/23/2009] [Indexed: 12/02/2022] Open
Abstract
Abdominal tuberculosis is not a rare disease, but obstructive jaundice caused by tuberculosis (tuberculous lymphadenitis, tuberculous enlargement of the head of pancreas, and/or tuberculous stricture of the biliary tree) is rare. We recently experienced a case of obstructive jaundice as a result of paradoxical reaction of periportal tuberculous lymphadenopathy that was treated successfully with corticosteroid and biliary drainage. No similar cases have been reported previously.
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Affiliation(s)
- Yun Jung Lee
- Division of Gastroenterology, Department of Internal Medicine, Eulji University College of Medicine, Eulji University Hospital, Daejeon, Korea
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