Pancreatic tuberculosis with splenic tuberculosis mimicking advanced pancreatic cancer with splenic metastasizes: a case report

Abstract

A 60-year-old woman presented with vague abdominal pain for one week was referred to pancreatic tail carcinoma accompanied with splenic metastasizes. She came to our hospital for further treatment. Ultrasonography and abdominal computed tomography (CT) revealed a pancreatic tail tumor with splenic metastasizes. There was no history of tuberculosis. Laparotomy was performed because pancreatic tail carcinoma with splenic metastasizes was highly suspected. Indurated mass in the pancreatic tail and sporadic metastasizes in the spleen had been found during the surgery. The pancreatic tail and the spleen were removed and proved to be tuberculosis on histological examination of a frozen section. The patient was given antituberculosis therapy and is now getting well. Tuberculosis should be considered in the differential diagnosis of pancreatic masses. The response to antituberculosis treatment is very favorable.

Figure 1

CT scans of the pancreas. CT scan of pancrease demonstrating a mass in the pancreatic tail () and metastasizes in the spleen (→).

Figure 2

Chest X-ray. Chest X- ray shows no TB signs.

Figure 3

(A and B) Histological examination. Fig 3A low power view of the pancreas demonstrating granulomatous inflammation () and Langhans' giant cells (→) (H & E stain, 10×); Fig 3B high power view of the same field of Fig 3A (H & E stain, 20×).