Isolated Pancreatic Tuberculosis

Pandita, Kamal Kishore; Sarla,; Dogra, Sandeep

doi:10.4103/0255-0857.53212

Cited by 11 publications

(5 citation statements)

References 6 publications

(7 reference statements)

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“…Our patient presented with non-specific epigastric pain and constitutional features consistent with the published literature to date on pancreatic TB [4, 5, 7, 9]. He had non-specific markers of chronic inflammatory disease/TB in the form of anaemia, elevated ESR and a positive tuberculin skin test.…”

Section: Discussionsupporting

confidence: 76%

“…Pancreatic involvement is reported in less than 5% of cases and it often occurs in the setting of disseminated TB and immunodeficiency states [2, 3]. Isolated pancreatic TB is still rare, with only a handful of cases reported to date [4–6]. The disease often emerges insidiously with non-specific constitutional symptoms, while the most common presentations of pancreatic TB include abdominal pain, jaundice and weight loss [5, 7].…”

Section: Discussionmentioning

confidence: 99%

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Isolated pancreatic tuberculosis masquerading as pancreatic cancer

Zacharia

Antony

Kolassery

et al. 2014

Gastroenterology Report

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Isolated pancreatic tuberculosis (TB) remains a rarity despite the high incidence of tuberculosis in many of the African and Asian countries. Presentation as discrete pancreatic mass often masquerades as pancreatic neoplasm and diagnosis may require histology. Extra-hepatic portal hypertension due to splenic vein thrombosis complicating pancreatic TB has been reported in the literature. We report here a case of isolated pancreatic TB with pancreatic head mass mimicking neoplasm with extra-hepatic portal hypertension. The possibility of TB should be considered in the list of differential diagnoses of pancreatic mass and an endoscopic, ultrasound-guided biopsy might help to clinch the diagnosis of this potentially curable disease.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Isolated pancreatic tuberculosis masquerading as pancreatic cancer

Zacharia

Antony

Kolassery

et al. 2014

Gastroenterology Report

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“…Among extrapulmonary sites, TB affecting the gastrointestinal tract is the sixth most common, with abdominal TB accounting for approximately 10% of cases [ 5 , 6 ]. Isolated pancreatic TB is very rare, even in endemic areas.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Cause of Pancreatic Tumor

Sabri,

Ahmed,

Rakhange

2024

Cureus

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Pancreatic tuberculosis (TB) is a rare condition that can be challenging to distinguish from other pancreatic neoplasms. We present the case of a 48-year-old Indian male who complained of persistent vague epigastric pain for two months. Other physicians saw him and treated him like a dyspeptic case. He gave a history of daily alcohol consumption. Routine investigations, including amylase and lipase levels, were within normal limits. However, an abdominal ultrasound revealed a cystic lesion in the body of the pancreas, prompting further investigation. A subsequent abdominal CT scan revealed a tumor of 6x4 cm in diameter with solid and cystic components in the pancreatic body. Although tumor markers were not remarkable, inflammatory markers showed elevated levels of ESR (erythrocyte sedimentation rate) of 95 mm/hr and CRP (C-reactive protein) of 83 mg/L, with normal hemoglobin. Endosonography (EUS) with fine needle aspiration (FNA) was performed to achieve a definitive diagnosis. EUS was performed with a linear echoendoscope, which revealed the mass, which had solid and cystic components. Fluid was aspirated from the cystic part and FNA passes were performed in the solid part. Microscopic examination and aspirated fluid culture confirmed the presence of Mycobacterium tuberculosis , while the solid part revealed caseation-indicated granulomas, indicative of TB. The patient was promptly initiated on a seven-month course of three anti-TB medications, leading to normalization of ESR and CRP levels during the treatment period. A follow-up abdominal CT scan showed complete resolution of the pancreatic lesion, indicating successful management. This case is rare and all the data in the literature is mainly in the form of case reports. Using EUS with FNA has transformed the diagnosis of pancreatic malignancy into a curable disease that could be easily managed with anti-TB medications.

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“…[24] CT-guided FNA in two female cases was done with history of epigastric pain radiating to back, and smears revealed caseous necrosis with positive AFB on ZN staining. [2526] Earlier single case reports showed epithelioid cell granulomas and smears were positive for AFB in ZN Stain. AFB culture and PCR studies were also positive in these cases.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic and peripancreatic tuberculosis presenting as hypoechoic mass and malignancy diagnosed by ultrasound-guided fine-needle aspiration cytology

Rao

Pandey

Rana

et al. 2013

J Cytol

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Background:Pancreatic and peripancreatic tuberculosis is an extremely uncommon disease, presenting as hypoechoic mass on ultrasonography and imaging mimicking malignancy. Consequently, it represents a diagnostic challenge.Aims:To study 14 unusual cases of pancreatic and peripancreatic tuberculosis undergoing ultrasound-/endoscopic-guided fine-needle aspiration cytology (FNAC) in the 5-year period from 2006 to 2010.Materials and Methods:Endoscopic-guided FNAC was done in two cases, while ultrasound-guided FNAC was performed in 12 cases using 22-G needles via a percutaneous transabdominal approach. The aspirated material was quickly smeared onto glass slides, air dried, and wet fixed in 95% ethyl alcohol for subsequent Papanicolaou staining.Results:All pancreatic and peripancreatic tuberculosis cases showed solid-cystic pancreatic mass. Smears showed epithelioid cell granulomas, multinucleated giant cells, mixed inflammatory cells and histiocytes against a necrotic background. The common anatomic locations were the head, peripancreatic, tail and body of the pancreas.Conclusions:Ultrasound-/endoscopic-guided FNAC is a safe, reliable and cost-effective method for preoperative diagnosis of pancreatic and peripancreatic tuberculosis. Clinical symptoms and accurate diagnostic approach by ultrasound-/endoscopic-guided FNAC of pancreatic and peripancreatic tuberculosis is needed to avoid performing redundant laparotomy. Despite its rarity, pancreatic and peripancreatic tuberculosis should be considered for differential diagnosis of pancreatic and peripancreatic cystic mass in endemic developing countries.

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Isolated Pancreatic Tuberculosis

Cited by 11 publications

References 6 publications

Isolated pancreatic tuberculosis masquerading as pancreatic cancer

Isolated pancreatic tuberculosis masquerading as pancreatic cancer

An Unusual Cause of Pancreatic Tumor

Pancreatic and peripancreatic tuberculosis presenting as hypoechoic mass and malignancy diagnosed by ultrasound-guided fine-needle aspiration cytology

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