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小儿胰腺结核:一例病例报告及文献综述

Pediatric Pancreatic Tuberculosis: A Case Report and Review of the Literature.

作者信息

Zhang Yajun, Tao Yuhong

机构信息

Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.

Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China.

出版信息

Case Rep Pediatr. 2018 Aug 30;2018:5215128. doi: 10.1155/2018/5215128. eCollection 2018.

Abstract

Pancreatic tuberculosis (TB) is an uncommon form of extrapulmonary TB and represents a diagnostic challenge for physicians. Pancreatic TB presents with nonspecific signs and symptoms and may mimic malignancy. However, pancreatic TB rarely occurs in children. Here, we present a case of a 5-year-old girl with pancreatic TB and markedly elevated serum cancer antigen- (CA-) 125 levels, thus raising the suspicion of malignancy, but positivity for DNA was noted. The patient recovered after being administered standard antitubercular therapy for one year. This case suggests that clinicians should have a heightened suspicion of pancreatic TB when faced with pancreatic lesions despite the fact that increased CA-125 may indicate malignancy. Laparoscopy combined with peritoneal biopsy and polymerase chain reaction (PCR) may provide a new method to confirm the diagnosis.

摘要

胰腺结核是肺外结核的一种罕见形式,对医生来说是一个诊断难题。胰腺结核表现为非特异性体征和症状,可能类似恶性肿瘤。然而,胰腺结核在儿童中很少见。在此,我们报告一例5岁女孩患胰腺结核且血清癌抗原(CA)-125水平显著升高的病例,这引发了对恶性肿瘤的怀疑,但发现DNA呈阳性。患者在接受标准抗结核治疗一年后康复。该病例表明,临床医生在面对胰腺病变时,即使CA-125升高可能提示恶性肿瘤,也应高度怀疑胰腺结核。腹腔镜检查联合腹膜活检和聚合酶链反应(PCR)可能为确诊提供一种新方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f19/6136468/bc0e79aeea9e/CRIPE2018-5215128.001.jpg

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