2018 Volume 32 Issue 1 Pages 153-159
A 70-year-old woman was referred to our hospital for evaluation of biliary stricture. The Magnetic Resonance cholangiopancreatography (MRCP) and the computed tomography (CT) showed extensive stricture from the perihiar to intrahepatic bile ducts. Transpapillary biliary forceps biopsy failed to confirm malignancy. Left hepatic trisectionectomy with bile duct resection were performed under diagnosis of Bismuth type IV perihilar cholangiocarcinoma. Pathologically, granulomas with caseous necrosis was found in the stenotic bile duct, leading the probable diagnosis of tuberculosis. Biliary tuberculoma, a rare disease, is difficult to diagnose accurately. Biliary tubeculosis should be recognized as a potential discriminatory disease for benign biliary stricture, because anti-tuberculosis therapy improves the associated stenosis,
