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Case Reports
. 2018 Apr 12:2018:7871503.
doi: 10.1155/2018/7871503. eCollection 2018.

Isolated Pancreatic Tuberculosis Mimicking Pancreatic Cancer: A Diagnostic Challenge

Abhishek Bhurwal  1 , Muhammad Masoodul Haq  1 , Sunil Sapru  1 , Matthew Tortora  2 , Dhanasekaran Ramasamy  3
Affiliations
Case Reports

Isolated Pancreatic Tuberculosis Mimicking Pancreatic Cancer: A Diagnostic Challenge

Abhishek Bhurwal et al. Case Rep Gastrointest Med. .

Abstract

Isolated pancreatic tuberculosis is an exceedingly rare condition, even in areas of the world where the disease is highly prevalent. Abdominal tuberculosis is a common form of extrapulmonary tuberculosis but involvement of the pancreas is very rare. We report a case of isolated pancreatic tuberculosis presenting as a pancreatic mass in a patient with persistent abdominal pain and jaundice. Clinically and radiologically, the mass mimicked a malignant pancreatic tumor with a vastly different prognostic implication and therapeutic approach. Endoscopic ultrasound with fine-needle aspiration (EUS-FNA) can provide valuable diagnostic information in this scenario. After the tissue showed evidence of acid-fast bacilli and the cultures showed growth of Mycobacterium tuberculosis, antituberculosis therapy was initiated. Conservative management is usually successful in alleviating symptoms and leading to a cure. The excellent response to ATT makes it imperative that these patients are diagnosed early and managed appropriately to avoid unnecessary surgery and associated morbidity.

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Figures

Figure 1
Figure 1
Initial MRCP showing pancreatic head mass with nonenhancing areas in the center.
Figure 2
Figure 2
Necrotic material on the needle aspiration smear (H&E stain).
Figure 3
Figure 3
Scattered acid-fast bacilli on the cell block preparation (acid-fast stain).
Figure 4
Figure 4
Follow-up imaging at 5 months showing resolution with no discrete pancreatic head mass.
See this image and copyright information in PMC

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