Misdiagnosis of pancreatic tuberculosis as a pancreatic cystic neoplasm - A case report

Abstract

Pancreatic tuberculosis is an extremely rare condition. Its non-specific clinical and radiological findings resemble pancreatic malignancy. Here, we report a case of pancreatic tuberculosis that presented with abdominal pain and dyspeptic symptoms for 2 months and was misdiagnosed as a pancreatic cystic neoplasm. Abdominal magnetic resonance imaging showed a well-demarcated exophytic lesion with multiple T2 high signals small cystic areas in the anterior superior part of the head of the pancreas measuring 23 × 20 × 28 mm. This patient has undergone laparotomy and excision of the pancreatic mass. Histological examination revealed granulomatous inflammation of a lymph node with caseation, which was pathognomonic of tuberculosis. She was treated for tuberculosis for 6 months and has become symptom free. The diagnosis of pancreatic tuberculosis could be misleading and should be considered when dealing with pancreatic masses in countries with high incidence.

Keywords: pancreatic neoplasm; pancreatic tuberculosis.

Figure 1.

Computed tomography (a) magnetic resonance imaging (b) scans showing a well-demarcated exophytic lesion in the anterior superior part of the head of the pancreas measuring 23 × 20 × 28 mm.

Figure 2.

Surgical specimen and histopathological features of pancreatic tuberculosis.