Isolated pancreatic tuberculosis masquerading as pancreatic cancer

Zacharia, George Sarin; Antony, Rajany; Kolassery, Sandesh; Ramachandran, Thazhath Mavali

doi:10.1093/gastro/gou017

Cited by 17 publications

(12 citation statements)

References 7 publications

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“…Clinical and imaging findings may closely mimic pancreatic cancer and differential diagnosis may be difficult [77]. Abdominal pain, jaundice, and weight loss are the most common presenting symptoms in both clinical situations [78]. The disease may focally or Fig.…”

Section: Pancreatic Tuberculosismentioning

confidence: 99%

Non-neoplastic hepatopancreatobiliary lesions simulating malignancy: can we differentiate?

et al. 2020

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Despite the success of cross-sectional imaging in evaluating hepatopancreatobiliary system malignancies, several nonmalignant disease processes may closely mimic malignancy. Differentiating these benign diseases from malignancy may be difficult, or even impossible, even in the hands of experienced imagers. In this manuscript, we present benign mimics involving the hepatopancreatobiliary system and try to increase awareness of these potential pitfalls.

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Section: Pancreatic Tuberculosismentioning

confidence: 99%

Non-neoplastic hepatopancreatobiliary lesions simulating malignancy: can we differentiate?

et al. 2020

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“…38 Occasional reports have indicated that unusual complications like arterial pseudoaneurysms and extra-hepatic portal venous obstruction may occur in patients with pancreatic tuberculosis. 28,42,43 These may result in gastrointestinal bleeding related to pseudo-aneurysmal bleeding or gastric varices. 28,43 Magnetic resonance imaging has been occasionally used in evaluation of pancreatic tuberculosis.…”

Section: Imaging Featuresmentioning

confidence: 99%

“…28,42,43 These may result in gastrointestinal bleeding related to pseudo-aneurysmal bleeding or gastric varices. 28,43 Magnetic resonance imaging has been occasionally used in evaluation of pancreatic tuberculosis. Magnetic resonance cholangiopancreatography may demonstrate dilatation of the bile and the pancreatic ducts because of obstruction by the tubercular pancreatic head mass.…”

Section: Imaging Featuresmentioning

confidence: 99%

Pancreatic tuberculosis

Sharma

Rana

Kumar

et al. 2016

J of Gastro and Hepatol

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Pancreatic tuberculosis is very rare, but recently, there has been a spurt in the number of reports on pancreatic involvement by tuberculosis. It closely mimics pancreatic cancer, and before the advent of better imaging modalities it was often detected as a histological surprise in patients resected for a presumed pancreatic malignancy. The usual presentation involves abdominal pain, loss of appetite and weight, jaundice which can be associated with cholestasis, fever and night sweats, palpable abdominal lump, and peripheral lymphadenopathy. Computed tomography (CT) of the abdomen is an important tool for evaluation of patients with pancreatic tuberculosis. This CT imaging yields valuable information about the size and nature of tubercular lesions along with the presence of ascites and lymphadenopathy. However, there are no distinctive features on CT that distinguish it from pancreatic carcinoma. Endoscopic ultrasound provides high resolution images of the pancreatic lesions as well as an opportunity to sample these lesions for cytological confirmation. The presence of granulomas is the most common finding on histological/cytological examination with the presence of acid fast bacilli being observed only in minority of patients. As there are no randomized or comparative studies on treatment of pancreatic tuberculosis it is usually treated like other forms of tuberculosis. Excellent cure rates are reported with standard anti tubercular therapy given for 6-12 months.

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“…Pancreatic/parapancreatic TB is an uncommon form of abdominal infection and has a rare occurrence even in endemic regions. It accounts for less than 5% of all tuberculosis in the developing world [ 3 ]. Many epidemiological analyses suggest that the probability of tuberculosis is much higher among human immunodeficiency virus- (HIV-) positive people.…”

Section: Introductionmentioning

confidence: 99%

Pancreatic Tuberculosis with Vascular Involvement and Peritoneal Dissemination in a Young Man

Zhu

Zhang

Wei

et al. 2017

Case Reports in Medicine

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Pancreatic tuberculosis (TB) is an extremely rare form of extrapulmonary tuberculosis even in endemic areas that masquerades as a mass or inflammation because of lack of typical clinical manifestations and radiologic features and therefore usually misdiagnosed as a pancreatic malignancy or pancreatitis. Here we present a 23-year-old young man with pancreatic tuberculosis mimicking pancreatic head carcinoma A man who suffered from upper abdominal pain and nausea for half a month was admitted to our hospital. Narrow band imaging (NBI) and gastroscopic imaging, together with endoscopic ultrasonography (EUS), revealed a duodenal bulb mucous prominences lesion. Computed tomography (CT) and magnetic resonance imaging (MRI) both suggested a pancreatic mass which resembled a pancreatic head tumor that had a higher risk of malignancy. The patient therefore accepted an exploratory laparotomy and pancreatoduodenectomy, Whipple operation. Biopsies of pancreas, duodenum, lymph nodes, omentum, and adipose tissues were all performed, revealing tuberculosis infection in pancreas, hepatic portal vein infiltration, and peritoneal dissemination. The patient was treated successfully after operation and recovered with standard anti-TB drugs for 6 months. Timely reporting of this rare case can help physicians improve their ability to identify several specific illnesses and diseases that share confusing signs or symptoms clinically and radiographically.

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Isolated pancreatic tuberculosis masquerading as pancreatic cancer

Cited by 17 publications

References 7 publications

Non-neoplastic hepatopancreatobiliary lesions simulating malignancy: can we differentiate?

Non-neoplastic hepatopancreatobiliary lesions simulating malignancy: can we differentiate?

Pancreatic tuberculosis

Pancreatic Tuberculosis with Vascular Involvement and Peritoneal Dissemination in a Young Man

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