A 58-year-old man presented to our hepatogastroenterology clinic with non-colicky pain in right hypochondrium and vomiting for 1 month. The pain was mild in intensity, dull, aching in nature, gradual in onset and progressive in course. It was non-radiating and not associated with meals. There was history of weight loss of 3 kg over a period of 1 month. There was no history of jaundice and tuberculosis or exposure to tuberculosis in the past. The general physical examination was unremarkable. There was no lymphadenopathy or abdominal visceromegaly. The laboratory investigations revealed raised ALP, 111 IU/L, Gamma-glutamyl transpeptidase (GGT), 61 IU/L and erythrocyte sedimentation rate (ESR), 70 mm/1sth; while complete blood count (CBC), renal function tests, coagulation profile and CA 19-9, 18.9u/ml (normal: 0-31u/ml) were within normal limits. Ultrasonography (US) of the abdomen revealed distended and irregular thick walled GB. Computed tomography (CT) of the abdomen revealed GB with irregularly thickened wall in the region of the fundus. There was an illness defined hypodense area extending from the body of GB to adjacent hepatic parenchyma measuring 3.0x1.5 cm and an enlarged lymph node at porta hepatis measuring 2.0x1.5 cm. The above constellation of findings raised a radiological suspicion of malignant lesion of GB (Figure 1). Bone scintigraphy and CT chest were negative for metastatic deposits. Based on the clinicoradiological diagnosis of GB carcinoma, extended cholecystectomy was planned. Diagnostic laparoscopy was done to get tissue diagnosis prior to the definitive procedure. It revealed adhesions around liver with multiple small whitish spots on its surface. Liver lesion biopsy was taken as well as two lymph nodes removed and sent for frozen section. The histopathological evaluation of frozen section of liver tissue revealed numerous caseating epithelioid granuloma containing Langhan's giant cells, consistent with tuberculosis (Figure 2). The sections examined from lymph nodes revealed benign reactive changes. Based on these findings, exploratory laparotomy was not done and the wound was closed. Patient was prescribed anti-tuberculous treatment (ATT) for one year. After 4 months of starting ATT, the patient improved markedly. His clinical symptoms completely disappeared. Repeated laboratory investigations revealed ESR 10 mm/1sth, and liver function tests (LFTs) also returned to normal levels. He is still on treatment and on regular follow-up.