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酷似癌的胰腺周围结核性淋巴结炎:病例报告

Peripancreatic tuberculous lymphadenitis mimicking carcinoma: report of a case.

作者信息

Sen M, Turan M, Karadayi K, Aslan M, Elagoz S

机构信息

Department of General Surgery, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.

出版信息

Acta Chir Belg. 2004 Jun;104(3):338-40. doi: 10.1080/00015458.2004.11679568.

Abstract

Peripancreatic tuberculous lymphadenitis is a rare clinical entity and it usually raises serious diagnostic problems. We report a case of a solitary abdominal tuberculoma. A 45-year old woman was admitted to hospital with obstructive jaundice. An exploratory laparotomy was performed. A conglomerated mass, penetrating into the pancreas was found. Since exact diagnosis could not be obtained by peroperative frozen sections, standard Whipple procedure, segmental portal vein resection and reconstruction with autogenous saphenous vein were performed. Histopathological examination of the resected specimen revealed tuberculous lymphadenitis. The patient was given an anti-tuberculous treatment and a good response was noted. Abdominal tuberculoma is often mistaken for a malignant neoplasm and a high grade of suspicion is neccessary in order to make the exact diagnosis and optimal medical treatment of this entity.

摘要

胰周结核性淋巴结炎是一种罕见的临床病症,通常会引发严重的诊断问题。我们报告一例孤立性腹部结核瘤病例。一名45岁女性因梗阻性黄疸入院。进行了剖腹探查术。发现一个融合性肿块,侵入胰腺。由于术中冰冻切片无法获得确切诊断,遂进行了标准的惠普尔手术、门静脉节段切除并采用自体大隐静脉重建。切除标本的组织病理学检查显示为结核性淋巴结炎。给予患者抗结核治疗,效果良好。腹部结核瘤常被误诊为恶性肿瘤,为准确诊断和对该病症进行最佳治疗,必须保持高度怀疑。

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