Sonthalia Nikhil, Ray Sayantan, Pal Partha, Saha Avishek, Talukdar Arunansu
Nikhil Sonthalia, Arunansu Talukdar, Department of General Medicine, Medical College and Hospital, Kolkata 700073, India.
World J Clin Cases. 2013 Aug 16;1(5):181-6. doi: 10.12998/wjcc.v1.i5.181.
Tuberculosis (TB) involving the pancreas are uncommon, especially when present in immunocompetent hosts. Pancreatic TB is more frequently associated with miliary TB or widely disseminated disease. Pancreatic TB may present as cystic or solid pancreatic masses, pancreatic abscess or acute or chronic pancreatitis. Majority of the cases are diagnosed after surgical exploration for presumed pancreatic malignancy and pre-operative diagnosis is quite difficult. However, improvement in imaging techniques and the resulting image-guided interventions gradually can obviate the need for more invasive diagnostic surgical procedures and expedite the planning of therapy. Herein, we report a rare case of isolated pancreatic TB which presented with pancreatic mass lesion in an immunocompetent host. Diagnosis was made by contrast enhanced computed tomography and guided fine needle aspiration of the pancreatic mass which revealed acid-fast bacilli on Ziehl-Neelsen stain. The case was treated successfully with antituberculous drugs. Pancreatic tuberculosis should be considered in the differential diagnosis of a pancreatic mass when the patient is young, residing in the endemic zone of tuberculosis. Every attempt should be made to diagnose the cases to prevent unnecessary operation.
胰腺结核并不常见，尤其是在免疫功能正常的宿主中。胰腺结核更常与粟粒性结核或广泛播散性疾病相关。胰腺结核可表现为胰腺囊性或实性肿块、胰腺脓肿或急性或慢性胰腺炎。大多数病例是在因疑似胰腺恶性肿瘤而进行手术探查后才得以诊断，术前诊断相当困难。然而，成像技术的改进以及由此产生的影像引导干预措施逐渐可以避免进行更具侵入性的诊断性外科手术，并加快治疗方案的制定。在此，我们报告一例罕见的孤立性胰腺结核病例，该病例在免疫功能正常的宿主中表现为胰腺肿块病变。通过对比增强计算机断层扫描和对胰腺肿块进行引导下细针穿刺抽吸确诊，齐-尼氏染色显示抗酸杆菌。该病例经抗结核药物治疗成功。当患者年轻且居住在结核病流行地区时，胰腺结核应被列入胰腺肿块的鉴别诊断中。应尽一切努力诊断此类病例以避免不必要的手术。
