Incidental hepatic tuberculosis during planned resection of locally advanced ampullary carcinoma: a case report

Hoe, Vee Chuan; Khairuddin, Allim; Tan, Jun Sam; Sharif, Mohd Sharifudin; Azizan, Nornazirah; Hayati, Firdaus

doi:10.1186/s12893-020-00806-8

Cited by 3 publications

(4 citation statements)

References 11 publications

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“…It continues to infect a vast segment of society every year with an estimated 10 million individuals contracting TB and 1.6 million eventually succumbing to the disease in 2017 [1] . In Malaysia, TB does not only cause morbidity on the pulmonary tuberculosis (PTB), but also on the extra-pulmonary type [2–4] . The sputum smear test is widely used to diagnose PTB.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of delayed sputum smear conversion among pulmonary tuberculosis patients in Kota Kinabalu, Malaysia

et al. 2021

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Smear-positive pulmonary tuberculosis (SPPTB) is the major contributor to the spread of tuberculosis (TB) infection, and it creates high morbidity and mortality worldwide. The objective of this study was to determine the predictors of delayed sputum smear conversion at the end of the intensive phase of TB treatment in Kota Kinabalu, Malaysia.This retrospective study was conducted utilising data of SPPTB patients treated in 5 TB treatment centres located in Kota Kinabalu, Malaysia from 2013 to 2018. Pulmonary TB (PTB) patients included in the study were those who had at least completed the intensive phase of anti-TB treatment with sputum smear results at the end of the 2nd month of treatment. The factors associated with delayed sputum smear conversion were analyzed using multiple logistic regression analysis. Predictors of sputum smear conversion at the end of intensive phase were evaluated.A total of 2641 patients from the 2013 to 2018 periods were included in this study. One hundred eighty nine (7.2%) patients were identified as having delayed sputum smear conversion at the end of the intensive phase treatment. Factors of moderate (advanced odd ratio [aOR]: 1.7) and advanced (aOR: 2.7) chest X-ray findings at diagnosis, age range of >60 (aOR: 2.1), year of enrolment 2016 (aOR: 2.8), 2017 (aOR: 3.9), and 2018 (aOR: 2.8), smokers (aOR: 1.5), no directly observed treatment short-course (DOTS) supervisor (aOR: 6.9), non-Malaysian citizens (aOR: 1.5), and suburban home locations (aOR: 1.6) were associated with delayed sputum smear conversion at the end of the intensive phase of the treatment.To improve sputum smear conversion success rate, the early detection of PTB cases has to be fine-tuned so as to reduce late or severe case presentation during diagnosis. Efforts must also be in place to encourage PTB patients to quit smoking. The percentage of patients assigned with DOTS supervisors should be increased while at the same time ensuring that vulnerable groups such as those residing in suburban localities, the elderly and migrant TB patients are provided with proper follow-up treatment and management. Abbreviations: 95% CI = 95% confidence interval, AFB = acid fast bacilli, aOR = advanced odd ratio, DOTS = directly observed treatment short-course, EPTB = extrapulmonary tuberculosis, Mtb = Mycobacterium tuberculosis, PTB = pulmonary tuberculosis, SPPTB = smear-positive pulmonary tuberculosis, TB = tuberculosis, TBTC = tuberculosis treatment centres.

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Section: Introductionmentioning

confidence: 99%

“…[1] In Malaysia, TB does not only cause morbidity on the pulmonary tuberculosis (PTB), but also on the extrapulmonary type. [2][3][4] The sputum smear test is widely used to diagnose PTB. PTB treatment targets include sputum smear conversion at the end of the intensive phase of anti-TB treatment.…”

Section: Introductionmentioning

confidence: 99%

Predictors of delayed sputum smear conversion among pulmonary tuberculosis patients in Kota Kinabalu, Malaysia

et al. 2021

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“…TB is deemed endemic in Malaysia, with 29,000 new cases annually and an incidence rate of 92 cases per 100,000 population in 2018 6 . From this, there are a minority of cases that involved extrapulmonary TB, including gastrointestinal TB 7–9 . Hence, this report presents a rare case of a colo‐appendico‐duodenal fistula, which to the extent of the authors' knowledge, is the first case reported in our region.…”

Section: Introductionmentioning

confidence: 71%

Colo‐appendico‐duodenal fistula: Rare presentation of extrapulmonary tuberculosis

Gan

Sibin

Payus

et al. 2021

Clinical Case Reports

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“…The ileo-caecal junction is the most commonly affected area in abdominal tuberculosis, besides other hollow organs [1]. Solid organs such as the liver, spleen or kidneys occur more commonly than the pancreas [2]. Herein, we describe a case of disseminated tuberculosis involving the pancreas, mimicking a clinical presentation of advanced pancreatic carcinoma.…”

Section: Introductionmentioning

confidence: 93%

The great masquerader of pancreatic tuberculosis

Chan

Sellappan

Maiyauen

et al. 2022

Egypt J Radiol Nucl Med

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Background Pancreatic tuberculosis is a rare clinical entity. It represents a diagnostic challenge as the clinical presentation may mimic pancreatic malignancy. Case presentation A 66-year-old gentleman presented with an incidental finding of a pancreatic tail mass on routine ultrasonography of the abdomen whilst working up on chronic kidney disease. He denied abdominal pain, fever, night sweats, constitutional symptoms or tuberculosis contact. On examination, there was no palpable mass per abdomen. The tumour marker of Ca 19-9 was normal. Ultrasonography revealed a lobulated heterogeneous hypovascular and hypoechoic mass at the tail of the pancreas. Contrast-enhanced computed tomography (CT) of the thorax and abdomen revealed a thickened right pleura, right pleural effusion with right lung collapsed consolidation and multiple mediastinal lymph nodes. There is an ill-defined hypodense mass seen in the tail and body of the pancreas measuring 3 × 7 × 3 cm with the presences of calcification within. The constellation of CT findings suggests a pancreatic malignancy with metastasis to the lungs. Endoscopic ultrasonography (EUS) assessment showed an irregular hypoechoic mass measuring 3.0 × 2.7 cm at the tail of the pancreas. Multiple rounded hypoechoic lesions were also seen scattered within the body of the pancreas with multiple enlarged para-aortic lymph nodes. A fine-needle aspiration biopsy of the lesion was consistent with granulomatous inflammation. The diagnosis of disseminated tuberculosis was made. The patient was subsequently started on antitubercular medication and recovered well. Conclusion A high index of suspicion is needed to diagnose pancreatic tuberculosis, especially in patients whose radiological imaging shows a pancreatic mass with necrotic peripancreatic lymphadenopathy in endemic countries. EUS-guided fine-needle aspiration is the diagnostic modality of choice, and vigorous attempts should be made at obtaining a preoperative histological or bacteriological diagnosis to avoid unnecessary surgery.

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Incidental hepatic tuberculosis during planned resection of locally advanced ampullary carcinoma: a case report

Cited by 3 publications

References 11 publications

Predictors of delayed sputum smear conversion among pulmonary tuberculosis patients in Kota Kinabalu, Malaysia

Predictors of delayed sputum smear conversion among pulmonary tuberculosis patients in Kota Kinabalu, Malaysia

Colo‐appendico‐duodenal fistula: Rare presentation of extrapulmonary tuberculosis

The great masquerader of pancreatic tuberculosis

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