A 65-year-old man was admitted for treatment of necrotizing pneumonia in the right upper lung field and consulted to gastrointestinal department for evaluation of a hypoechoic mass in the celiac region. Vital signs were stable. Initial laboratory findings included hemoglobin 10.6 g/dL, aspartate aminotransferase 64 IU/L, alanine aminotransferase 83 IU/L, and C-reactive protein 4.58 mg/dL. Abdominal ultrasonography for elevated liver function tests showed a 3.5-cm hypoechoic mass in the porta hepatis (Fig. 1A) and multiple gallstones. Abdominal computed tomography revealed a 3.5-cm low-density, multi-lobulated mass at the celiac axis suggestive of tuberculous lymphadenopathy (Fig. 1B). Endoscopic ultrasound showed a 27-mm hypoechoic mass in the celiac region (Fig. 1C) and fine needle aspiration showed benign epithelial cells with lymphocytes and histiocytes. Polymerase chain reaction for tuberculosis and acid-fast staining of the aspirate were negative. Laparoscopic excisional biopsy of an enlarged celiac lymph node was performed. Histologic examination of the specimen showed a squamous epithelium-lined cyst containing keratin material, confirming the diagnosis of an epidermal inclusion cyst (EIC) within a lymph node (Fig. 2).