Korean J Gastroenterol.  2021 Oct;78(4):245-248. 10.4166/kjg.2021.070.

Tuberculosis of Cystic Duct Lymph Node Associated with Cholecystitis

• Heo TG
• Hong SW
• Chang YG
• Lee WY
• Ohe HJ
• Choi KW
• Kang YK

• KMID: 2521500
• DOI: http://doi.org/10.4166/kjg.2021.070

Abstract

Tuberculosis of the cystic duct lymph node is very rare. Only four cases have been reported in the literature. This paper presents the case of a young male patient with a tuberculous cystic duct lymph node and chronic cholecystitis, who was diagnosed with cystic duct stones and a gall bladder polyp preoperatively.

Keyword

Tuberculosis; Cystic duct; Lymph nodes

Figure

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  Fig. 1 Abdominal computed tomography shows (A) collapsed gallbladder with a minute cholesterol polyp (arrow), (B) a tuberculous cystic duct node preoperatively suspected of being a cystic duct stone (arrow), (C) mottled calcification at the periphery of the pancreatic uncinate process (arrow).

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  Fig. 2 Abdominal ultrasonography shows a cystic duct node, which was misdiagnosed preoperatively as short segmental tubular thickening of the distal cystic duct (arrows).

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  Fig. 3 (A) Cut surface of the enlarged peri-cystic duct lymph node showed a central area of pale yellowish caseous necrosis. (B) Microscopically, several epithelioid granulomas (dotted circles), and amorphous, granular, eosinophilic caseous necrosis (asterisk) were observed (hematoxylin and eosin, ×200). Ziehl-Neelsen staining revealed acid-fast bacilli (inlet, ×600).

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