A Case of Gallbladder Tuberculosis Diagnosed by Positive Tuberculosis-Polymerase Chain Reaction

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.

Rare Presentation of Gall Bladder Tuberculosis in a Non Immuno-Compromised Patient

“…4 The diagnosis is usually made on histological examination of the gall bladder specimen after cholecystectomy. 5 Sensitivity of acid-fast stain and culture result is low, histopathological diagnosis of gall bladder tuberculosis can be very demanding. TB-polymerase chain reaction can also be performed on the resected specimen, which has high sensitivity and specificity.…”

“…TB-polymerase chain reaction can also be performed on the resected specimen, which has high sensitivity and specificity. 5 Gall bladder TB should be considered in the differential diagnosis of diseases with an irregular, hypodense thickened gall bladder wall with pericholecystic edematous changes and abdominal wall abscess.…”

Tuberculous gallbladder - A rare presentation of tuberculosis

“…The first case of tuberculosis of gall bladder in the world literature was described in 1870 by Gaucher. [2] In 1908, Simmonds [7] collected 8 cases from the literature including two of his own cases. The first case from Kashmir was reported by Akhter et all and the second by Misgar et al [4]…”