Ota Hideo, Hoshino Hiromitsu, Jokoji Ryu, Arisaka Yoshifumi, Mizuno Hitoshi
Department of Gastroenterological Surgery, Nippon Life Hospital, Osaka, JPN.
Department of Gastroenterological Surgery, Itami City Hospital, Itami, JPN.
Cureus. 2024 Apr 1;16(4):e57382. doi: 10.7759/cureus.57382. eCollection 2024 Apr.
Cancer (including pancreatic cancer) can develop following a infection within one year of tuberculosis infection. However, it is unclear whether tuberculosis infection increases the risk of developing adenosquamous carcinoma of the pancreas (ASCP), an extremely rare cancer with a poorer prognosis than pancreatic ductal adenocarcinoma (PDAC). Herein, we report a case of rapid growing ASCP discovered upon a resection for neck tuberculous lymphadenitis. The patient was a 57-year-old woman. An excisional biopsy of the swollen right neck lymph nodes revealed tuberculous lymphadenitis. One month after the biopsy, an abdominal computed tomography scan showed a 2.0 cm (diameter) ischemic tumor in the pancreatic tail. The tissue obtained using endoscopic ultrasonography-guided fine-needle aspiration led to the pathological diagnosis of ASCP. Two months after the biopsy, the tumor had grown to 3.5 cm (diameter), and invasion of the stomach and colon was suspected. Distal pancreatectomy, splenectomy, partial gastrectomy, and transverse colectomy were performed. The final diagnosis was ASCP (4.7 cm, pT3, pN0, cM0, and pStage IIA). Postoperative adjuvant combination chemotherapy combined with antituberculosis drugs was administered orally. We report the first case of rapidly growing adenosquamous carcinoma resected from the pancreas in association with tuberculous lymphadenitis. Additional evidence is needed to confirm that tuberculosis infection increases the risk of developing pancreatic adenosquamous cell carcinoma because its potential role in promoting squamous metaplasia is unclear.
癌症（包括胰腺癌）可在结核感染后一年内发生。然而，尚不清楚结核感染是否会增加胰腺腺鳞癌（ASCP）的发病风险，ASCP是一种极其罕见的癌症，其预后比胰腺导管腺癌（PDAC）更差。在此，我们报告一例因颈部结核性淋巴结炎切除时发现的快速生长的ASCP病例。患者为一名57岁女性。对右侧颈部肿大淋巴结进行切除活检，结果显示为结核性淋巴结炎。活检后一个月，腹部计算机断层扫描显示胰尾有一个直径2.0厘米的缺血性肿瘤。通过内镜超声引导下细针穿刺获取的组织经病理诊断为ASCP。活检后两个月，肿瘤已长至直径3.5厘米，怀疑侵犯了胃和结肠。遂进行了胰体尾切除术、脾切除术、部分胃切除术和横结肠切除术。最终诊断为ASCP（4.7厘米，pT3，pN0，cM0，pIIA期）。术后口服辅助联合化疗并联合抗结核药物。我们报告了首例与结核性淋巴结炎相关的从胰腺切除的快速生长的腺鳞癌病例。由于结核感染在促进鳞状化生中的潜在作用尚不清楚，因此需要更多证据来证实结核感染会增加胰腺腺鳞癌的发病风险。
