Tuberculous lymphadenitis as a cause of obstructive jaundice: Report of a case

We report a rare case of obstructive jaundice caused by enlarged tuberculous lymph nodes compressing the common bile duct in the retropancreatic region, mimicking pancreatic cancer. A 32-year-old man was admitted to our hospital with a 1-month of history of jaundice. An abdominal computed tomography (CT) scan showed a tumor in the pancreatic head, but an endoscopic retrograde cholangiopancreatogram (ERCP) showed a normal pancreatic duct system. Positron emission tomography with 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG-PET) revealed a hot spot only in the pancreatic head. Under a presumptive diagnosis of malignancy, a laparotomy was performed and an intraoperative biopsy specimen revealed epithelioid granuloma with caseous necrosis, which led us to suspect tuberculous lymphadenitis.,,: This diagnosis was confirmed by culture, and antituberculous therapy was commenced postoperatively. The patient has not suffered any further episodes of obstructive jaundice. This case report demonstrates that positive FDG-PET results should be interpreted carefully when diagnosing tumors of the pancreatic head.