Wu C S, Wang S H, Kuo T T
Dept. of Hepato-Gastroenterology, Chang-Gung Memorial Hospital, Taiwan, Republic of China.
Infection. 1994 Jul-Aug;22(4):287-9. doi: 10.1007/BF01739920.
A 24-year-old man presented with vague abdominal fullness and a mild epigastric dull pain for about 3 months was found to have a pancreatic head tumor at a medical center 2 months ago. He came to our hospital for further treatment. Ultrasonography, endoscopic retrograde cholangiopancreatography (ERCP) and abdominal computed tomography (CT) all revealede a pancreatic head tumor. Laparotomy was performed because pancreatic head carcinoma was highly suspected. Indurated mass in the pancreatic head, enlarged lymph nodes and white tubercles on the intestine proved to be tuberculosis on histological examination of a frozen section. Acid fast bacilli were also found. The patient was given antituberculous therapy and is now doing well. To avoid unnecessary laparotomy, CT, echo-guided percutaneous aspiration cytology or biopsy and culture of the tissue for mycobacteria should be done in a patient with pancreatic mass, especially in a region where pulmonary and abdominal tuberculosis are common.
一名24岁男性，出现腹部隐约胀满和上腹部轻度钝痛约3个月，2个月前在一家医疗中心被发现患有胰头肿瘤。他来我院寻求进一步治疗。超声检查、内镜逆行胰胆管造影（ERCP）和腹部计算机断层扫描（CT）均显示有胰头肿瘤。由于高度怀疑为胰头癌，故行剖腹手术。胰头硬结肿块、肿大淋巴结及肠上白色结节经冰冻切片组织学检查证实为结核。还发现了抗酸杆菌。该患者接受了抗结核治疗，目前情况良好。为避免不必要的剖腹手术，对于有胰腺肿块的患者，尤其是在肺结核和腹部结核常见的地区，应进行CT、超声引导下经皮穿刺抽吸细胞学检查或活检以及组织培养以查找分枝杆菌。
