Jenney A W, Pickles R W, Hellard M E, Spelman D W, Fuller A J, Spicer W J
Department of Microbiology and Infectious Diseases, Alfred Hospital, Prahran, Victoria, Australia.
Scand J Infect Dis. 1998;30(2):99-104. doi: 10.1080/003655498750003438.
Tuberculosis (TB) is most commonly diagnosed as a pulmonary disease; however, haematogenous spread of the organism can cause disease in any organ system. We report the case of a 30-y-old woman, Human Immunodeficiency Virus (HIV) antibody-negative, who was diagnosed as having a pancreatic mass on computed tomographic (CT) scans. She underwent a laparotomy and the fluid drained from the mass was culture-positive for Mycobacterium tuberculosis. We review the clinical details of 37 similar cases of pancreatic TB in the literature, where each patient's HIV antibody status is negative or unknown. In this series 3 patients died (1 of these had commenced anti-TB therapy, the others had not) but the remaining 34 responded well to radiological-guided drainage and/or surgical intervention and anti-TB therapy. TB should be considered in the differential diagnosis of a pancreatic mass, especially when associated with epigastric pain or discomfort and weight loss.
结核病(TB)最常被诊断为肺部疾病;然而,该病原体的血行播散可导致任何器官系统发病。我们报告一例30岁女性病例,该女性人类免疫缺陷病毒(HIV)抗体阴性,计算机断层扫描(CT)显示其胰腺有肿物。她接受了剖腹手术,从肿物中引流出来的液体结核分枝杆菌培养呈阳性。我们回顾了文献中37例类似胰腺结核病例的临床细节,这些患者的HIV抗体状态均为阴性或不明。在这个系列中,有3例患者死亡(其中1例已开始抗结核治疗,其他2例未开始),但其余34例对放射引导下引流和/或手术干预以及抗结核治疗反应良好。在胰腺肿物的鉴别诊断中应考虑结核病,尤其是当伴有上腹部疼痛或不适以及体重减轻时。