Gallbladder tuberculosis camouflaging as gallbladder cancer – case series and review focussing on treatment

Abstract

Abstract:Introduction: Gallbladder tuberculosis, in an endemic region, is a common infectious etiology affecting a rare organ. The high prevalence of carcinoma gallbladder in the endemic regions of tuberculosis, like India, poses diagnostic dilemma. Case series: We are reporting three cases of gallbladder tuberculosis mimicking carcinoma gallbladder of which the first two cases were operated with a presumptive diagnosis of malignancy. The third case presented to us after laparoscopic cholecystectomy elsewhere and on evaluation was found to have disseminated tuberculosis. Discussion: The lack of pathognomonic clinical and radiological characters results in histological surprise of gallbladder tuberculosis following surgery performed for other indications like malignancy. In preoperatively diagnosed patients medical management plays pivotal role in management. Surgery is required in symptomatic patients. On the other hand, histologically proven cases following surgical resection require antitubercular therapy. Conclusion: Previous history of tuberculosis or concomitant tuberculosis at other sites may provide clue to the diagnosis of biliary tuberculosis. Antitubercular treatment after surgery plays an important role in preventing further dissemination.

Granulomatous inflammation of gall bladder mimicking an impacted common bile duct stone

“…Hepatobiliary tuberculosis constitutes less than 1% of the total abdominal tuberculosis cases [3]. Low incidence of gallbladder tuberculosis is largely attributed to the high content of bile, alkaline pH and other inhibitory substances [4,5]. Tubercular infection may spread to gallbladder by peritoneal, lymphatic, hematogenous or ascending routes [5].…”

“…This disease needs differentiation from acute and chronic cholecystitis including xanthogranulomatous cholecystitis, carcinoma and polypoidal lesions of gallbladder [4]. Regional lymphnodal enlargement is seen in both gallbladder tuberculosis and malignancy.…”

“…Radiological findings of the gallbladder may raise the suspicion of malignancy [1]. Diagnosis is often made postoperatively on histopathology examination [4,5]. Herein, we present a case of a young male who presented with recurrent right upper abdominal pain, treated as a case of impacted CBD stone, was incidentally diagnosed as tubercular cholecystitis.…”

Gallbladder Tuberculosis Mimicking Gallbladder Carcinoma: A Case Report and Review of the Literature

“…Gallbladder tuberculosis (GT) is an extremely rare clinical entity that represents only 1% of abdominal tuberculosis cases [1]. The clinical presentation and the radiological findings are not specific, thereby making preoperative diagnosis difficult, and it is usually misdiagnosed as gallbladder carcinoma (GC) [2]. The diagnosis is usually made upon histological examination after cholecystectomy.…”

Specific cholecystitis: An unusual presentation of extrapulmonary tuberculosis

“…Gall bladder infection by M. tuberculosis is a rare manifestation and can be mistaken for malignant disease (Krishnamurthy et al, 2016). Diagnosis remains challenging and is often made only after surgery (Liu et al, 2016).…”