Figure 3.

Case 3 A 56-year-old woman presented with obstructive jaundice (2 months) associated with cholangitis and previous cholecystectomy (8 years ago). Fig 3 a) MRCP done showed dilated intrahepatic radicals with stricture below confluence (white arrow). 3 b) PTBD done to relieve cholangitis shows stricture below confluence (white arrow). At exploration 2 × 1 cm mass in CBD encasing portal vein with multiple pericholedochal lymph nodes. She underwent palliative hepaticojejunostomy and biopsy of the bile duct and lymph node 3 c) Histopathology sections examined under low power (40×) show epitheloid cell granuloma with central area of caseous necrosis (black arrow). At the periphery multiple ducts are seen with periductal chronic inflammation and fibrosis. 3 d) Sections examined under high power (200×) show ducts with dense chronic inflammatory infiltrates comprising of lymphocytes along with periductal fibrosis (black arrow). Final diagnosis: Biliary tuberculosis