Arai Jun, Kitamura Katsuya, Yamamiya Akira, Ishii Yu, Nomoto Tomohiro, Honma Tadashi, Ishida Hiroo, Shiozawa Eisuke, Takimoto Masafumi, Yoshida Hitoshi
Division of Gastroenterology, Department of Medicine, Showa University School of Medicine, Japan.
Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan.
Intern Med. 2017;56(9):1049-1052. doi: 10.2169/internalmedicine.56.7509. Epub 2017 May 1.
We performed endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) on a patient presenting with an asymptomatic peripancreatic mass-like lesion. The aspiration cytologic finding was class II. On positron emission tomography-computed tomography (PET-CT), there were hot spots in the left supra-clavicular lymph node and the peripancreatic lesion. A whole biopsy of the left supra-clavicular lymph node revealed tuberculous lymphadenitis. Polymerase chain reaction (PCR) using tissue obtained via EUS-FNA showed that the peripancreatic mass-like lesion was also positive for tuberculosis. We made a diagnosis of peripancreatic tuberculous lymphadenitis. In patients with enlarged lymph nodes, including those in the abdominal area, tuberculous lymphadenitis is a potential diagnosis.
我们对一名出现无症状胰周肿块样病变的患者进行了内镜超声引导下细针穿刺抽吸术(EUS-FNA)。抽吸细胞学检查结果为II级。在正电子发射断层扫描-计算机断层扫描(PET-CT)上,左锁骨上淋巴结和胰周病变处有热点。左锁骨上淋巴结的全组织活检显示为结核性淋巴结炎。使用通过EUS-FNA获得的组织进行的聚合酶链反应(PCR)表明,胰周肿块样病变也呈结核阳性。我们诊断为胰周结核性淋巴结炎。在包括腹部淋巴结肿大的患者中,结核性淋巴结炎是一种可能的诊断。