Pancreatic tuberculosis mimicking pancreatic carcinoma during anti-tuberculosis therapy: A case report

Abstract

Pancreatic tuberculosis (TB) is a rare condition, even in immunocompetent hosts. A case is presented of pancreatic TB that mimicked pancreatic head carcinoma in a 40-year-old immunocompetent male patient. The patient was admitted to our hospital after suffering for nine days from epigastralgia and obstructive jaundice. Computed tomography revealed a pancreatic mass that mimicked a pancreatic head carcinoma. The patient had undergone an operation four months prior for thoracic TB and was undergoing anti-TB therapy. A previous abdominal ultrasound was unremarkable with the exception of gallbladder steroid deposits. The patient underwent surgery due to the progressive discomfort of the upper abdomen and a mass that resembled a pancreatic malignancy. A biopsy of the pancreas and lymph nodes was performed, revealing TB infection. The patient received a cholecystostomy tube and recovered after being administered standard anti-TB therapy for 15 mo. This case is reported to emphasize the rare contribution of pancreatic TB to pancreatic masses and obstructive jaundice.

Keywords: Anti-tuberculosis therapy; Pancreatic head carcinoma; Pancreatic mass; Pancreatic tuberculosis; Tube cholecystostomy.

Figure 1

Computed tomography of a pancreatic tuberculosis lesion. Computed tomography revealed a necrotic and calcified cystic lesion (white arrows) with well-defined margins in the head of the pancreas; the lesion mimicked pancreatic head carcinoma.

Figure 2

Histopathology of lymph node biopsies. Ziehl-Neelsen staining of a lymph node biopsy from the pancreatic region revealed granulomatous inflammation with necrosis and acid-fast bacilli (black arrow; magnification × 400).