Pancreatic Tuberculosis in an Immunocompetent Patient: A Case Report and Review of the Literature

Abbaszadeh, Mahsa; Rezai, Jalal; Hasibi, Mehrdad; Larry, Mehrdad; Ostovaneh, Mohammad Reza; Javidanbardan, Sanam; Mirbagheri, Seyed Amir

doi:10.15171/mejdd.2017.80

Cited by 6 publications

(4 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Pancreatic tuberculosis is very rare and, in most cases, has been reported in immunosuppressed patients or in the context of disseminated disease [13]. The low probability of Mycobacterium tuberculosis localization at the pancreatic level could be explained by the retroperitoneal location of the pancreas and the antimicrobial properties of its enzymes, such as lipase and deoxyribonucleases extracts [14,15]. The diagnosis of pancreatic tuberculosis may be hampered by the difficulty of detecting acid-fast bacilli (AFB) in the biopsy sample, as most forms of abdominal tuberculosis are paucibacillary [16].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pancreatic Tuberculosis—A Condition That Mimics Pancreatic Cancer

et al. 2022

View full text Add to dashboard Cite

Tuberculosis is a disease with serious consequences in terms of morbidity and mortality. Pancreatic localization is very rare and is mostly encountered in patients with immunosuppressive disorders. A 59-year-old woman with arterial hypertension, grade 2 obesity, and a history of cholecystectomy, was admitted for fever (38.5 °C), jaundice, and marked physical asthenia. The blood tests showed severe metabolic acidosis, with partial respiratory compensation, mild microcytic normochromic anemia, inflammatory syndrome, procalcitonin value ten times the upper limit of normal, nitrogen retention syndrome, hypoalbuminemia, hypertriglyceridemia, hypercholesterolemia, and moderate hyponatremia. The electrocardiogram, chest X-ray, and abdominal ultrasound did not show any significant pathological changes. Contrast-enhanced computed tomography raised the suspicion of acute-on-chronic pancreatitis and subsequent evaluation by magnetic resonance imaging raised the suspicion of a pancreatic tumor. Pancreatic fine needle biopsy under echoendoscopic guidance revealed purulent material, which was sent for cytological and bacteriological examination. The Ziehl-Neelsen stain showed acid-alcoholic resistant bacilli, while bacterial cultures were positive for gentamicin and tigecycline-sensitive Klebsiella. The diagnosis of pancreatic tuberculosis was established. Pancreatic tuberculosis is a very rare condition that often mimics pancreatic cancer. The peculiarity of the case is the appearance of pancreatic tuberculosis in an immunocompetent woman and the association with Klebsiella infection.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Abbaszadeh et al presented another case of pancreatic tuberculosis in a 23-year-old woman without significant comorbidities. In this case, the diagnosis was established after obtaining the tissue sample by exploratory laparotomy [15].…”

Section: Discussionmentioning

confidence: 99%

Pancreatic Tuberculosis—A Condition That Mimics Pancreatic Cancer

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Primary pancreatic TB (PPTB) is an isolated involvement of the pancreas or peripancreatic lymph nodes by TB in the absence of previously identified TB and involvement of any other organ [ 2 ]. Owing to the hidden location of the pancreas in the retroperitoneum along with the antimycobacterial properties of its enzymes, pancreatic TB is a rare entity [ 3 - 4 ]. It manifests itself, both clinically and radiologically, as a pancreatic malignancy.…”

Section: Discussionmentioning

confidence: 99%

“…CT findings may include hypodense lesions with irregular borders most commonly in the head of the pancreas, or enlarged peripancreatic lymph nodes [ 8 ]. Findings that may suggest mycobacterial infection include the presence of rim-enhanced lymph nodes in the peripancreatic region and a thickened bowel wall in the ileocecal region [ 4 ]. An important image finding in pancreatic TB is the normal-appearing common bile duct and the pancreatic duct, regardless of the location of the mass.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic Tuberculosis: A Diagnostic Dilemma

Haseeb

Bilal²,

Bokhari

et al. 2021

Cureus

View full text Add to dashboard Cite

Despite the high prevalence of tuberculosis (TB) in developing countries, pancreatic TB remains a rare disease. Pancreatic TB usually presents as fever, night sweats, and abdominal pain in an immunocompromised individual. We present a case of a patient with end-stage renal disease undergoing pre-transplant workup who had an incidental finding of a pancreatic mass and necrotic peri-pancreatic lymph nodes on a CT scan. The patient was diagnosed via endoscopic ultrasound-guided biopsy as pancreatic TB. Anti-TB therapy was started with positive results.

show abstract

Calcified peripancreatic lymph nodes in pancreatic and hepatic tuberculosis mimicking pancreatic malignancy

et al. 2018

View full text Add to dashboard Cite

Rationale:Tuberculosis remains a serious menace to the health of people. Isolated hepatic tuberculosis is rare and pancreatic tuberculosis is extremely rare. The preoperative diagnosis of pancreatic tuberculosis remains a great challenge.Patient concerns:A 58-year-old Asian woman was referred to our hospital for evaluation of low back pain for 4 years and abdominal pain for 1 month.Diagnoses:Computed tomography (CT) of the abdomen showed a hypodense mass in the pancreatic head and neck with abundant calcifications, a hypodense lesion in the liver without calcification, peripancreatic lymphadenopathy, calcifications in some lymph nodes. CT-guided fine needle aspiration biopsy of the hepatic lesion was carried out and the cytological examination revealed hepatic tuberculosis.Interventions:The patient was treated with antituberculous therapy for 1 year.Outcomes:Low back pain and abdominal pain disappeared 3 months after initial treatment and after 2 year of follow-up, the patient was asymptomatic.Lessons:Our data hint that calcifications in both pancreatic lesions and peripancreatic lymph nodes may suggest pancreatic tuberculosis rather than pancreatic malignancy.

show abstract

Pancreatic Tuberculosis in an Immunocompetent Patient: A Case Report and Review of the Literature

Cited by 6 publications

References 4 publications

Pancreatic Tuberculosis—A Condition That Mimics Pancreatic Cancer

Pancreatic Tuberculosis—A Condition That Mimics Pancreatic Cancer

Pancreatic Tuberculosis: A Diagnostic Dilemma

Calcified peripancreatic lymph nodes in pancreatic and hepatic tuberculosis mimicking pancreatic malignancy

Contact Info

Product

Resources

About