Hari S, Seith A, Srivastava D N, Makharia G, Pal S
All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029.
Trop Gastroenterol. 2005 Jul-Sep;26(3):141-3.
Pancreatic tuberculosis is very rare, especially in immunocompetent patients, and represents a diagnostic challenge. The clinical features in patients with pancreatic tuberculosis are usually non-specific. The radiological features mimic pancreatic malignancy or pancreatitis. We describe a case of pancreatic tuberculosis mimicking carcinoma on Computed tomography scan. Ultrasound guided fine needle aspiration cytology (FNAC) showed caseating granulomatous inflammation. The diagnosis of pancreatic tuberculosis was made and the patient was put on anti-tubercular therapy. Five months later, a repeat CT scan of the abdomen revealed resolution of the pancreatic lesion. We emphasize that tuberculosis should now be included in the differential diagnosis of a pancreatic mass. Diagnostic indicators include the association of a pancreatic mass with fever, the presence of abdominal pain and a cystic pancreatic mass in a younger patient coming from a region where tuberculosis is endemic.
胰腺结核非常罕见,尤其是在免疫功能正常的患者中,并且是一个诊断难题。胰腺结核患者的临床特征通常不具有特异性。影像学特征类似胰腺恶性肿瘤或胰腺炎。我们描述了一例在计算机断层扫描上表现为酷似癌的胰腺结核病例。超声引导下细针穿刺抽吸细胞学检查(FNAC)显示干酪样肉芽肿性炎症。确诊为胰腺结核后,患者接受了抗结核治疗。五个月后,腹部重复CT扫描显示胰腺病变消退。我们强调,现在应将结核纳入胰腺肿块的鉴别诊断中。诊断指标包括胰腺肿块伴有发热、腹痛以及来自结核病流行地区的年轻患者出现胰腺囊性肿块。