Primary tuberculosis of cystic duct lymph node

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.

Heterotopic pancreatic tissue in the gall bladder neck and lymph node surrounding cystic duct identified during cholecystectomy for chronic calculous cholecystitis: a rare case report from Syria

“…However, it may be complicated by inflammation, bleeding, obstruction or malignant transformation [ 7 ]. The differential diagnosis of the enlargement of cystic duct lymph node includes cholecystitis, tuberculosis, ectopic tissue and lymphoma or metastasis [ 8 ]. Our first diagnosis was reactive lymphadenopathy in context of chronic cholecystitis.…”

Tuberculosis of Cystic Duct Lymph Node Associated with Cholecystitis

“…To the best of the author's knowledge, only four cases have been reported since 2004. [1][2][3][4] All cases had right upper quadrant pain and were suspected of having cholecystitis preoperatively. The exact diagnosis of the cystic duct or pericholedochal tuberculous lymphadenitis is important for proper medical treatment and for avoiding unnecessary surgery.…”