A 57-year-old male presented with abdominal pain, fatigue, high fever, and weight loss of 6 kg for two months. His previous medical history was unremarkable. Physical examination revealed pain on the left side of the abdomen and hepatosplenomegaly. Laboratory findings were as follows: erythrocyte sedimentation rate 86 mm/h, leukocyte 12600/microl, neutrophile 7200/microl, thrombocyte 510000/microl, monocyte 2100/microL, hemoglobin 10.2 g/dl, hematocrit 30%, MCV 74.6 fl, and lymphocyte 2200/microl. Computed tomography (CT) of the chest showed multiple mediastinal lymphadenopathies (maximum size 15 mm) and bilateral apical fibrotic bands. A uniform-density mass lesion of 70 mm that filled retrovesical and left pelvic area was detected in abdominal CT. The lesion surrounded superior part of sigmoid colon and there were multiple lymph nodes in the retro-vesical, celiac, para-aortic and para-iliac areas (Figure 1). Histological examination of samples that were obtained during diagnostic laparotomy showed epithelioid granulomas, Langhans? type multinucleated giant cells, and caseous necrosis (Figure 2). Lowenstein-Jensen culture of samples confirmed the presence of TB. Antituberculous therapy comprising rifampicin, isoniazid, ethambutol and pyrazinamide was initiated and continued for two months, and the patient was maintained on rifampicin and isoniazid for 6 months. In the sixth month follow-up of patient, cerebrovascular hemorrhage developed. The patient died due to this.