Sarcoidosis associated obstructive jaundice
Past history of sarcoidosis. Now jaundice, weight loss and low grade fever. CT showed mass of lymph nodes in root of small bowel mesentery and ultrasound demonstrated dilated intra-hepatic ducts. MRCP for clarification.
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Hilar mass lesion causing gross stricturing of the right and left hepatic ducts - looks like a Klatskin cholangiogarcinoma (Bismuth type IV). Key to the case is the past history of sarcoidosis and finding of abnromal lymph nodes around the aorta and in the small bowel mesentery.