Ezratty A, Gumaste V, Rose E, Sachar D B, Tiscornia-Wasserman P
Department of Medicine, Mount Sinai School of Medicine, City University of New York, New York.
J Clin Gastroenterol. 1990 Feb;12(1):74-7.
A 40-year-old man with prolonged constitutional symptoms and clinical evidence of pancreatitis and biliary tract obstruction underwent exploratory laparotomy. Intraoperative liver and pancreatic biopsies revealed acid-fast bacilli. Mycobacterium tuberculosis subsequently grew from both sputum and urine cultures. The patient responded well to antituberculosis therapy, although 8 months later, he returned with acquired immunodeficiency syndrome (AIDS) and died of large cell lymphoma 1.5 years later. A review of the literature showed that most similar cases of pancreatic tuberculosis were diagnosed only at postmortem examination. A high index of suspicion and attention to special stains are warranted for diagnosis of this frequently fatal, but potentially curable, disease.
一名40岁男性，伴有长期全身症状，并有胰腺炎和胆道梗阻的临床证据，接受了剖腹探查术。术中肝脏和胰腺活检发现抗酸杆菌。随后痰和尿培养均培养出结核分枝杆菌。患者对抗结核治疗反应良好，尽管8个月后，他因获得性免疫缺陷综合征（AIDS）复诊，1.5年后死于大细胞淋巴瘤。文献回顾显示，大多数类似的胰腺结核病例仅在尸检时才被诊断出来。对于这种常致命但可能治愈的疾病的诊断，需要高度的怀疑指数并重视特殊染色。
