Pancreatic tuberculosis mimicking carcinoma

Chandrasekhara, Kota L.; Iyer, Swaminath K.; Stanek, Albert; Herbstman, Horace

doi:10.1016/s0016-5107(85)72255-9

Cited by 21 publications

(14 citation statements)

References 10 publications

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“…A history of tuberculosis is also reported in only a minority of patients [3]. Patients with pancreatic tuberculosis can present variably, in the form of locally advanced or metastatic pancreatic cancer [3, 16, 19], pancreatic abscess [17, 20], acute pancreatitis [21], chronic pancreatitis [18]or portal hypertension [22]. All these presentations were seen in our patients.…”

Section: Discussionmentioning

confidence: 66%

Pancreatic Tuberculosis: Still a Histopathological Diagnosis

Chaudhary¹,

Negi²,

Sachdev³

et al. 2002

Dig Surg

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Background: Pancreatic tuberculosis is usually unsuspected as it can present in various forms. Though an uncommon disease, once diagnosed it is potentially curable. Patients and Methods: Retrospective review of the records of 9 patients with histologically proven tuberculosis of the pancreas. Results: In none of the 9 patients was a preoperative diagnosis of tuberculosis possible. The diagnoses considered included: pancreatic cancer (n = 5); acute pseudocyst (n = 1); pancreatic abscess (n = 1); chronic pancreatitis with pancreatic head mass (n = 1), and carcinoma of the colon causing massive lower gastrointestinal bleeding (n = 1). All the patients underwent surgery. The diagnosis of tuberculosis was confirmed by histopathological examination of biopsy specimens obtained at the time of laparotomy. One patient died, the remaining patients received antitubercular therapy and are doing well at a median follow-up period of 26 months. Conclusion: In view of the nonspecific and variable clinical presentation and atypical radiological signs, a clinical diagnosis of pancreatic tuberculosis is usually not possible. Therefore there should be a high index of suspicion for this disease in young patients residing in endemic areas. Our experience highlights the importance of performing biopsy in apparently inoperable pancreatic mass lesions.

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Section: Discussionmentioning

confidence: 66%

Pancreatic Tuberculosis: Still a Histopathological Diagnosis

Chaudhary¹,

Negi²,

Sachdev³

et al. 2002

Dig Surg

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“…Various modes of presentation have previously been reported including pancreatic abscess [7], acute [8] or chronic pancreatitis [9], gastrointestinal bleeding [10], obstructive jaundice [11], portal vein obstruction [12] or a pancreatic mass mimicking carcinoma [13]. The case presented is the first to report a patient with primary pancreatic TB presenting with features of a carcinoma of the head of the pancreas with bony metastases.…”

Section: Discussionmentioning

confidence: 97%

Tuberculosis of the Pancreas Presenting as Metastatic Pancreatic Carcinoma

Evans¹,

Hamanaka²,

Olliff

et al. 2000

Dig Surg

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“…Only 26 cases of pancreatic tuberculosis were found to have been reported in the English literature . The patients usually presented with such manifestations as cough, abdominal pain, anorexia, poor appetite, fever, chill, fatigue, weight loss, upper gastrointestinal bleeding [12], biliary duct obstruction [3,5], pancreatic duct obstruction [13], acute pancreatitis [19], chronic pancreatitis [7,11], pancreatic mass mimicking carcinoma [10,20,21,23], and pancreatic abscess [9, 15-20, 24, 25]. Abdominal uttrasonography or CT was performed in all but one case.…”

Section: Discussionmentioning

confidence: 99%

“…The presentation was an abscess or carcinomalike lesion. ERCP was done in only five patients and demonstrated a mass in three cases [10,21,23], stricture of the pancreatic duct with adjacent calcifications in one [7] and normal pancreatogram in one case where even a large mass was present [27]. Only three cases were successfully diagnosed by sonographically or CT-guided percutaneous aspiration in 1989 and 1992 [18,26,27].…”

Section: Discussionmentioning

confidence: 99%

“…This mistake demonstrates again that it is mandatory to obtain histological proof of pancreatic carcinoma since pancreatic tuberculosis may be present even in those who are generally healthy, and may mimic carcinoma in all imaging studies. Up to now, all efforts of ultrasound or CT-guided aspirations [18,26,27] and biopsy [10] have failed to establish histological proof, but simultaneous staining for acid-fast bacilli [18,26] or mycobacterial cultures [26,27] provided a definite diagnosis. In summary, we consider it impossible to differentiate pancreatic tuberculosis from pancreatic carcinoma on the basis of clinical manifestations and imaging studies.…”

Section: Discussionmentioning

confidence: 99%

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Pancreatic tuberculosis mimicking pancreatic head carcinoma: A case report and review of the literature

Wang

Kuo

1994

Infection

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A 24-year-old man presented with vague abdominal fullness and a mild epigastric dull pain for about 3 months was found to have a pancreatic head tumor at a medical center 2 months ago. He came to our hospital for further treatment. Ultrasonography, endoscopic retrograde cholangiopancreatography (ERCP) and abdominal computed tomography (CT) all revealede a pancreatic head tumor. Laparotomy was performed because pancreatic head carcinoma was highly suspected. Indurated mass in the pancreatic head, enlarged lymph nodes and white tubercles on the intestine proved to be tuberculosis on histological examination of a frozen section. Acid fast bacilli were also found. The patient was given antituberculous therapy and is now doing well. To avoid unnecessary laparotomy, CT, echo-guided percutaneous aspiration cytology or biopsy and culture of the tissue for mycobacteria should be done in a patient with pancreatic mass, especially in a region where pulmonary and abdominal tuberculosis are common.

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Pancreatic tuberculosis mimicking carcinoma

Cited by 21 publications

References 10 publications

Pancreatic Tuberculosis: Still a Histopathological Diagnosis

Pancreatic Tuberculosis: Still a Histopathological Diagnosis

Tuberculosis of the Pancreas Presenting as Metastatic Pancreatic Carcinoma

Pancreatic tuberculosis mimicking pancreatic head carcinoma: A case report and review of the literature

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