Jemni Imen, Akkari Imen, Mrabet Soumaya, Jazia Elhem Ben
Gastroenterology Department, Farhat Hached Hospital, Sousse, Tunisia.
Faculty of Medicine, Ibn Al Jazzar, Sousse, Tunisia.
Radiol Case Rep. 2020 Jul 10;15(9):1575-1578. doi: 10.1016/j.radcr.2020.06.041. eCollection 2020 Sep.
Isolated pancreatic tuberculosis is a very rare condition, even in areas of the world where the disease is highly prevalent. We report the case of isolated pancreatic tuberculosis in 54-year-old immunocompetent women, presenting as a solid mass of the pancreatic head with multiple lymphadenopathy mimicking a pancreatic carcinoma. The diagnosis was made with endoscopic ultra sound with fine needle aspiration and the treatment with anti-tuberculosis agents allowed the disappearance of the pancreatic mass and the regional lymphadenopathy. This case emphasizes the diagnostic challenge of this disease based on imaging findings because of a wide range of anomalies as carcinoma like masses, cystic lesions, or abscesses, which makes the Endoscopic ultrasound with fine needle aspiration the diagnostic modality of choice for pancreatic tuberculosis providing tissue samples for staining, cytology, culture, and polymerase chain reaction assay. Through this case we show that it is imperative to suspect pancreatic tuberculosis, as an appropriate treatment with antituberculosis drugs allows full recovery and avoids unnecessary surgery.
孤立性胰腺结核是一种非常罕见的疾病，即使在世界上该疾病高发地区也是如此。我们报告了一例54岁免疫功能正常女性的孤立性胰腺结核病例，表现为胰头实性肿块并伴有多发淋巴结肿大，酷似胰腺癌。通过内镜超声引导下细针穿刺活检做出诊断，抗结核药物治疗使胰腺肿块和区域淋巴结肿大消失。由于该疾病存在多种异常表现，如癌样肿块、囊性病变或脓肿，基于影像学表现诊断具有挑战性，这使得内镜超声引导下细针穿刺活检成为胰腺结核的首选诊断方式，可为染色、细胞学检查、培养及聚合酶链反应检测提供组织样本。通过该病例我们表明，怀疑胰腺结核至关重要，因为适当的抗结核药物治疗可实现完全康复并避免不必要的手术。
