A Case of Biliary Tract Tuberculosis Indistinguishable from Solid and Cystic Tumor of the Pancreas

A case of biliary tract tuberculosis that was difficult to differentiate from solid and cystic tumor (SCT) of the pancreas was treated. The patient was a 25-year-old woman from Philippines. She was admitted to our hospital with complaints of dull continuous upper right quadrant pain. Laboratory findings showed no abnormality. Abdominal ultrasonography and computed tomography revealed a multi-lobular cystic mass with solid components. Celiac angiography showed dilation and displacement of the epitholedochal plexus. Portography showed stenosis and displacement of the main trunk of the portal vein. No significant findings of tumor stains or encasements were found. A solid and cystic tumor of the pancreas was our preoperative diagnosis. Laparotomy was performed and frozen pathological examination revealed no malignant cells, but Langhans' giant cells were found. The tumor was resected. The postoperative pathological diagnosis was tuberculous adenitis. The morphological features of tuberculous adenitis of the biriary tract are similar to SCT of the pancreas. Therefore, a means of differential diagnosis has to emerge.