Pancreatic tuberculosis: an elusive diagnosis

Abstract

Tuberculosis should be considered in the differential diagnosis of an obscure pancreatic mass, and the condition is readily curable.

Isolated Pancreatic Tuberculosis Mimicking Pancreatic Cancer: A Diagnostic Challenge

“…Even though, tuberculosis primarily affects the lungs, isolated abdominal tuberculosis is not rare with incidence ranging from 0.59% to 12% [1, 8]. Pancreatic tuberculosis was first described by Auerbach in 1944 [9].…”

“…Isolated pancreatic tuberculosis is an exceedingly rare condition, even in areas of the world where the disease is highly prevalent [1]. The diagnosis is often a challenge as the symptoms and radiological appearance often mimic pancreatic cancer.…”

Pancreatic tuberculosis: a rare cause of pseudoneoplasic obstructive jaundice

“…Abdominal tuberculosis ranks third in the list of sites of extrapulmonary tuberculosis, after lymph nodes and genitourinary [2]. Pancreatic tuberculosis is extremely rare and still more rarely primary; it is usually due to miliary tuberculosis and associated with other digestive sites of tuberculosis, such as the peritoneum, liver, and spleen [2][3][4]. Auerbach reported in 1944 that 4.7% of 297 autopsy cases of miliary tuberculosis involved the pancreas [5].…”

“…It has been postulated that tuberculosis bacilli reach the pancreas only by hematogenous dissemination from undetectable lesions or by extension from contiguous lymph nodes [4,7]. Clinical findings are unspecific and may include chronic abdominal pain [2,3,[7][8][9][10][11][12], pseudoneoplasic obstructive jaundice [4,11,[13][14][15], digestive bleeding [16], chronic or acute pancreatitis, or pancreatic abscess [15,17]. In this case, the initial clinical finding was jaundice, due to blockage of the common bile duct by a pancreatic mass.…”

Isolated tuberculosis of the pancreas mimicking a pancreatic tumor with concomitant choledocholithiasis

“…Hence, bacteriological confirmation may not be attained in the early clinical course [13]. However, with the emergence of new technology such as polymerase chain reaction-based assay, a positive result can be obtained earlier even when microscopic examination and cultures of these tissues are negative [14].…”