From the *Department of Nuclear Medicine, †Department of Pathology, and ‡Department of Radiology, Changhai Hospital, Shanghai, China.
Clin Nucl Med. 2014 Jan;39(1):67-70. doi: 10.1097/RLU.0b013e318279c170.
Common bile duct (CBD) tuberculosis is rare. A 39-year-old woman was referred because of a 5-month history of abdominal pain. Abdominal enhanced MRI and CT showed dilatation of the distal CBD with irregularly thickened wall. Enhanced CT revealed enlarged retroperitoneal lymph nodes. FDG PET/CT showed increased FDG uptake of the CBD lesion and several retroperitoneal lymph nodes with slight FDG uptake. CBD cholangiocarcinoma with retroperitoneal lymph node metastasis was suspected. CBD tuberculosis was confirmed by endoluminal biopsy. Tuberculosis should be considered in the differential diagnosis of abnormal biliary FDG accumulation, particularly in tuberculosis endemic areas.
胆总管（CBD）结核较为罕见。一名 39 岁女性因腹痛 5 个月就诊。腹部增强 MRI 和 CT 显示 CBD 远端扩张，壁不规则增厚。增强 CT 显示腹膜后淋巴结肿大。FDG PET/CT 显示 CBD 病变和几个腹膜后淋巴结 FDG 摄取增加，摄取轻微。胆总管癌伴腹膜后淋巴结转移的可能性大。经内镜活检证实为 CBD 结核。在鉴别诊断异常胆道 FDG 积聚时，特别是在结核病流行地区，应考虑结核的可能。
