Endoscopic ultrasonographic diagnosis of pancreatic tuberculosis in immunocompetent patients—A case series from eastern India

Chakraborty, Debajyoti; Ghosh, Ranajoy; Halder, Ajay; Mondal, Dodul; Misra, Debashis

doi:10.1007/s12664-021-01171-x

Cited by 6 publications

(5 citation statements)

References 8 publications

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“… 12 Non-invasive approach of EUS with fine needle aspiration and TB PCR is used currently to evaluate patients with cystic neoplasms suspected to have TB. 13 , 14 Pancreatic tuberculosis is a curable condition with multi-drug anti-tuberculous chemotherapy (streptomycin, rifampin, isoniazid, pyrazinamide and ethambutol), which is given for 6–12 months. 5 Response to treatment can be assessed symptomatically and radiologically.…”

Section: Discussionmentioning

confidence: 99%

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

Lakmal,

Jayarajah,

Chandraguptha

et al. 2023

SAGE Open Medical Case Reports

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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.

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Section: Discussionmentioning

confidence: 99%

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

Lakmal,

Jayarajah,

Chandraguptha

et al. 2023

SAGE Open Medical Case Reports

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“…However, in recent years, with the increase in reported cases and the continuous improvement of ultrasound or CT-guided puncture biopsy technology, most reported cases of pancreatic tuberculosis can be diagnosed before the operation. [6,7] Endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) has been proved to be a good method for cytological diagnosis of pancreatic tuberculosis. [8] The diagnosis of pancreatic tuberculosis is based on histopathology or microbiological examination of specimens obtained from the pancreas.…”

Section: Discussionmentioning

confidence: 99%

“…In terms of clinical manifestations, abdominal pain was the most common symptom in patients, followed by weight loss, low fever, jaundice, or acute pancreatitis. [6,7,[17][18][19][20][21][22][23][24][25][26] We retrospectively analyzed the cases of pancreatic tuberculosis published in the past 2 years and found that except one case without abdominal pain, the other cases all showed abdominal pain. It is obviously different from low back pain caused by pancreatic cancer.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic tuberculosis misdiagnosed for surgical treatment: clinical analysis of 3 cases and literature review

Zhou,

Wang,

et al. 2023

Journal of Pancreatology

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The incidence rate of pancreatic tuberculosis (PT) is low, and it is difficult to distinguish from pancreatic malignant tumor before operation. We present three patients diagnosed after surgical treatment. All three cases involved female patients who were admitted due to primary manifestation of abdominal pain. These patients did not exhibit symptoms such as jaundice or back pain, and their tumor markers were within normal range. The surgical interventions employed included partial resection of the tumor in one case, mass resection in another, and pancreaticoduodenectomy in the third. Preoperative puncture biopsy is essential for diagnosing pancreatic tuberculosis, and it should be actively conducted on patients with suspected cases. We summarize several common manifestations of pancreatic tuberculosis to find the possibility of tuberculosis during preoperative evaluation and avoid misdiagnosis and unnecessary surgery.

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“…In this issue of the Indian Journal of Gastroenterology, Chakraborty and colleagues, School of Digestive and Liver Diseases, IPGME & R, Kolkata, India, present a case series of 117 patients with a pancreatic mass lesion [24]. All patients underwent endoscopic ultrasound with fine needle aspiration for diagnosis.…”

Section: Endoscopic Ultrasonographic Diagnosis Of Pancreatic Tubercul...mentioning

confidence: 99%

Editorial commentary on Indian Journal of Gastroenterology—November–December 2021

Limdi

2021

Indian J Gastroenterol

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Fetuin-A in newly detected type 2 diabetes mellitus as a marker of non-alcoholic fatty liver diseaseA growing body of evidence implicates hepatokines such as fetuin-A and fetuin-B in the prognoses of non-alcoholic fatty liver disease (NAFLD), its associated complications and in the development of obesity, hyperglycemia, hypertriglyceridemia, and chronic diseases, such as metabolic syndrome, type 2 diabetes mellitus (T2DM), and cardiovascular disease [1]. The association between Fetuin-A in newly diagnosed T2DM (NDD) and its corelation with NAFLD is less well understood.Yamasandhi and colleagues from Ramaiah Memorial Hospital, Bangalore, India, report a case-control study measuring fetuin-A levels in 60 NDD's with and without NAFLD [2]. Fetuin-A was significantly higher in NDD with NAFLD compared to those without NAFLD and showed an increasing trend with the advancement of fibrosis. A cut-off value of 1239 mcg/mL was able to differentiate NAFLD patients with area under curve (AUC) of 0.667 (sensitivity 75%; specificity 61%) and remained significant after adjustment for potential confounders such as age, weight, blood pressure, lipids, and liver enzymes. These findings need validation, but open up new perspectives in early diagnosis, identification of novel biomarkers, and providing novel targets for pharmacological interventions.

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Endoscopic ultrasonographic diagnosis of pancreatic tuberculosis in immunocompetent patients—A case series from eastern India

Cited by 6 publications

References 8 publications

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

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

Pancreatic tuberculosis misdiagnosed for surgical treatment: clinical analysis of 3 cases and literature review

Editorial commentary on Indian Journal of Gastroenterology—November–December 2021

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