In view of the clinical suspicion and laboratory and imaging findings, exploratory laparotomy was performed. The procedure allowed the visualization of lymphonomegalies in the hepatic hilum, periaortic and peripancreatic regions and a lymph node biopsy was obtained. The anatomicopathological examination showed a chronic fungal granulomatous lymphadenitis suggestive of paracoccidioidomycosis with positive Grocott special staining in the fungal structures (Figure 3), with negative alcohol-acid-resistant bacilli research and no signs of malignancy. The patient was diagnosed with secondary jaundice to extrinsic compression of the fungal lymph node by PCM, and treatment with once a day oral 200 mg Itraconazole was initiated.