García Del Olmo Nuria, Boscà Robledo Andrea, Penalba Palmí Rafael, Añón Iranzo Elena, Aguiló Lucía Javier
Cirugía General, Hospital Lluís Alcanyís. Xátiva, ESPAÑA.
Cirugía General, Hospital Lluís Alcanyís. Xátiva.
Rev Esp Enferm Dig. 2017 Jul;109(7):528-530. doi: 10.17235/reed.2017.4811/2016.
Primary peripancreatic lymph node tuberculosis is an exceptional entity in immunocompetent patients, but its incidence is increasing in developed countries in recent years due to increasing immigration. It usually presents as a pancreatic mass and is misdiagnosed as pancreatic neoplasia in most cases, with the diagnosis of tuberculosis occurring after surgery. We report the case of a 38 year old Pakistani man with abdominal pain of several months duration, who was initially diagnosed with a pancreatic neoplasm after detecting a mass in the pancreatic isthmus by computed tomography (CT) and abdominal magnetic resonance imaging (MRI). However, after performing an endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB), the patient was diagnosed with peripancreatic lymph node tuberculosis. After receiving anti-tuberculous treatment, the patient presented clinical improvement, despite a small reduction in the lesion size. In conclusion, peripancreatic lymph node tuberculosis is part of the differential diagnosis of pancreatic neoplasia. Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) represents a valuable and useful diagnostic tool for detecting this pathology, avoiding surgeries with a high morbidity and mortality.
原发性胰腺周围淋巴结结核在免疫功能正常的患者中是一种罕见疾病，但近年来由于移民增加，其在发达国家的发病率呈上升趋势。它通常表现为胰腺肿块，在大多数情况下被误诊为胰腺肿瘤，结核病的诊断在手术后才得以明确。我们报告了一例38岁的巴基斯坦男性患者，其腹痛持续数月，最初通过计算机断层扫描（CT）和腹部磁共振成像（MRI）在胰腺峡部发现肿块后被诊断为胰腺肿瘤。然而，在进行内镜超声引导下细针穿刺活检（EUS-FNAB）后，该患者被诊断为胰腺周围淋巴结结核。接受抗结核治疗后，尽管病变大小略有缩小，但患者的临床症状有所改善。总之，胰腺周围淋巴结结核是胰腺肿瘤鉴别诊断的一部分。内镜超声引导下细针穿刺活检（EUS-FNAB）是检测这种疾病的一种有价值且有用的诊断工具，可避免具有高发病率和死亡率的手术。
