Tuberculous abscess of the pancreas

Levine, Robert L.; Tenner, Scott; Steinberg, William M.; Ginsberg, Allen L.; Borum, Marie L.; Huntington, Diane K.

doi:10.1007/bf01300301

Cited by 27 publications

(10 citation statements)

References 14 publications

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“…A history of tuberculosis is also reported in only a minority of patients [3]. Patients with pancreatic tuberculosis can present variably, in the form of locally advanced or metastatic pancreatic cancer [3, 16, 19], pancreatic abscess [17, 20], acute pancreatitis [21], chronic pancreatitis [18]or portal hypertension [22]. All these presentations were seen in our patients.…”

Section: Discussionmentioning

confidence: 66%

Pancreatic Tuberculosis: Still a Histopathological Diagnosis

Chaudhary¹,

Negi²,

Sachdev³

et al. 2002

Dig Surg

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Background: Pancreatic tuberculosis is usually unsuspected as it can present in various forms. Though an uncommon disease, once diagnosed it is potentially curable. Patients and Methods: Retrospective review of the records of 9 patients with histologically proven tuberculosis of the pancreas. Results: In none of the 9 patients was a preoperative diagnosis of tuberculosis possible. The diagnoses considered included: pancreatic cancer (n = 5); acute pseudocyst (n = 1); pancreatic abscess (n = 1); chronic pancreatitis with pancreatic head mass (n = 1), and carcinoma of the colon causing massive lower gastrointestinal bleeding (n = 1). All the patients underwent surgery. The diagnosis of tuberculosis was confirmed by histopathological examination of biopsy specimens obtained at the time of laparotomy. One patient died, the remaining patients received antitubercular therapy and are doing well at a median follow-up period of 26 months. Conclusion: In view of the nonspecific and variable clinical presentation and atypical radiological signs, a clinical diagnosis of pancreatic tuberculosis is usually not possible. Therefore there should be a high index of suspicion for this disease in young patients residing in endemic areas. Our experience highlights the importance of performing biopsy in apparently inoperable pancreatic mass lesions.

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Section: Discussionmentioning

confidence: 66%

Pancreatic Tuberculosis: Still a Histopathological Diagnosis

Chaudhary¹,

Negi²,

Sachdev³

et al. 2002

Dig Surg

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“…Currently EUS biopsy is considered the ‘gold standard’ for diagnostic modality for pancreatic mass [5, 6]. Biopsy cytology in pancreatic TB shows granulomatous inflammation, epitheloid histiocytes, plasma cells and lymphocytes, while acid-fast bacilli are rarely seen [5, 8]. A positive mycobacterium tuberculosis culture is highly specific but is less sensitive and requires long incubation periods [8].…”

Section: Discussionmentioning

confidence: 99%

“…Biopsy cytology in pancreatic TB shows granulomatous inflammation, epitheloid histiocytes, plasma cells and lymphocytes, while acid-fast bacilli are rarely seen [5, 8]. A positive mycobacterium tuberculosis culture is highly specific but is less sensitive and requires long incubation periods [8]. Once diagnosed, pancreatic TB is treated with standard ATT of at least six months' duration.…”

Section: Discussionmentioning

confidence: 99%

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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“…They found only 24 reported cases of pancreatic involvement in the English-language literature. 4 The pathogenesis of pancreatic involvement remains obscure; however, some authors favor a lymphohematogenous dissemination from a small, undetected or reactivated primary or secondary tuberculous lesion. The primary focus may be in the intestine or retroperitoneal lymph nodes, with spread to the pancreas.…”

Section: Discussionmentioning

confidence: 99%

“…Abdominal lymph nodes, small intestine, cecum and peritoneum are the most commonly involved organs, whereas liver, large intestine, stomach and appendix are less frequently affected. 4 Atypical forms of gastrointestinal tuberculosis are more likely in immunocompromised individuals 5 than in immunocompetent ones. Because of its rarity and atypical presentation, a diagnostic dilemma always prevails in the case of a pancreatic mass, as a result of which the diagnosis was established postoperatively in many published studies, exposing patients to the trauma and complications of major surgery.…”

Section: A Patient Presented With Diabetes Mellitus and A Pancreatic mentioning

confidence: 99%