Division of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou, Zhejiang, China.
Division of Hepatobiliary and Pancreatic Surgery, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
J Int Med Res. 2023 Aug;51(8):3000605231189134. doi: 10.1177/03000605231189134.
A 41-year-old man was admitted to our department with a 7-day history of jaundice of the skin. He was misdiagnosed with carcinoma because imaging tests showed a space-occupying lesion in the pancreatic head, and laboratory examinations showed elevated liver enzymes, and elevated serum bilirubin, alpha-fetoprotein, carbohydrate antigen 19-9, and ferroprotein levels. However, there was slight calcification in the lesion and a subsequent T-Spot test result was positive. The patient then underwent endoscopic retrograde cholangiopancreatography for biopsy and bile drainage. Histologically, the pancreatic mass showed granulomatosis, and the pathologic diagnosis of the isolated pancreatic neoplasm was tuberculosis. The patient accordingly received anti-tuberculosis agents, resulting in a significant decrease in the size of the pancreatic mass. The patient recovered well. Pancreatic tuberculosis can masquerade as malignancy; however, careful attention to a differential diagnosis can prevent the need for laparotomy.
一位 41 岁男性因皮肤黄疸入院，病程 7 天。因影像学检查示胰头部占位性病变，实验室检查示肝酶升高，血清胆红素、甲胎蛋白、糖类抗原 19-9 和铁蛋白水平升高，患者被误诊为癌。然而，病变处有轻微钙化，随后 T 斑点试验结果阳性。患者随后接受经内镜逆行胰胆管造影活检和胆汁引流。组织学上，胰腺肿块显示肉芽肿，孤立性胰腺肿瘤的病理诊断为结核。因此，患者接受了抗结核药物治疗，胰腺肿块明显缩小。患者恢复良好。胰腺结核可能表现为恶性肿瘤；然而，仔细鉴别诊断可以避免开腹手术的需要。
