Tubercular Pancreatic Abscess Presenting as Fever and Cystic Pancreatic Lesion with Endoscopic Management

Fenkel, Jonathan M.; Spodik, Maya; Singu, Bheema S.; Infantolino, Anthony; Deshmukh, Sandeep; Loren, David E.

doi:10.1007/s10620-009-0938-6

Cited by 6 publications

(9 citation statements)

References 5 publications

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“…A total of 43 cases of HIV-positive patients with pancreatic TB (including the present case) were reviewed [2, . Of these cases, 40 were primarily analyzed [2,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][25][26][27][28][29][30][31][32][33][34][35][36][37][38] . Table 1 illustrates the clinical characteristics of the pancreatic TB patients with AIDS.…”

Section: Discussionmentioning

confidence: 99%

“…Gender [2,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][22][23][24][25][26][27][28][30][31][32][34][35][36][37][38] Male 28/39 (71.8) Female 11/39 (28.2) Known HIV-infected cases [2,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][25]…”

Section: Clinical Characteristics N (%)unclassified

“…n (%) Evidence of TB on chest X-rays [2,5,6,8-10,12-15,17-20,23-25,27-32,34 -37] 10/31 (32.3) Abnormal CT scans [2,[5][6][7][8][9][10][12][13][14][15][16][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] Pancreatic/peripancreatic mass with or without diffuse pancreatic enlargement 34/36 (94.4) Only diffuse pancreatic enlargement 1/36 (2.8) Small nodular lesions 1/36 (2.8) Topographic lesions of the pancreatic mass from all imaging studies [2,[5][6][7][8][9][10]12,13,15,16,[18][19][20][21][22]…”

Section: Diagnostic Studiesmentioning

confidence: 99%

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Pancreatic tuberculosis with acquired immunodeficiency syndrome: A case report and systematic review

Meesiri¹

2012

WJG

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Pancreatic tuberculosis (TB) is a relatively rare disease that can mimic carcinoma, lymphoma, cystic neoplasia, retroperitoneal tumors, pancreatitis or pseudocysts. Here, I report the case of a 31-year-old immigrant Burmese woman who exhibited epigastralgia, fever, weight loss and an epigastric mass. The patient was diagnosed with pancreatic TB and acquired immunodeficiency syndrome, and was treated with antituberculous drugs and percutaneous catheter drainage without a laparotomy. The clinical presentation, radiographic investigation and management of pancreatic TB are summarized in this paper to emphasize the importance of considering this rare disease in the differential diagnosis of pancreatic masses concomitant with human immunodeficiency virus infection. I also emphasize the need for both histopathological and microbiological diagnosis via fine-needle aspiration.

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Section: Discussionmentioning

confidence: 99%

Section: Clinical Characteristics N (%)unclassified

Section: Diagnostic Studiesmentioning

confidence: 99%

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Pancreatic tuberculosis with acquired immunodeficiency syndrome: A case report and systematic review

Meesiri¹

2012

WJG

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“…5 Diffuse or segmental, irregular enlargement of the head of the pancreas has also been reported. 6 There are only isolated case reports of tubercular pancreatic abscess, [7][8][9] where the diagnosis could be made on the basis of a positive AFB stain in the aspirated fluid. However, it is known that AFB may not be seen on staining of aspirated material or even on culture or cytology/histopathology if the bacterial load is low, as was in our case.…”

Section: Discussionmentioning

confidence: 99%

Malignant paraganglioma of the bile duct

Kurumboor¹

2013

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postoperative day 3 suggesting a pancreatic fistula. Drainage gradually reduced over a week and the drain was removed.Biopsy of the cyst wall revealed necrotizing epithelioid cell granulomas with Langhans giant cells suggestive of tuberculosis (Figure 4). Stain for AFB was again negative. A diagnosis of tubercular pancreatic abscess was made and the patient was started on antitubercular therapy (ATT). After 4 months of follow-up, the patient made a good recovery and was asymptomatic. ATT is ongoing and a 9-month course is planned.

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“…63 In summary, pancreatic tuberculosis mimics pancreatic cancer. This diagnostic possibility must be considered in patients with a pancreatic mass especially in individuals, residing in endemic countries or those who have a personal history of immunosuppression.…”

Section: Role Of Surgical and Other Therapeutic Options In Treatmentmentioning

confidence: 99%

Pancreatic tuberculosis

Sharma

Rana

Kumar

et al. 2016

J of Gastro and Hepatol

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Pancreatic tuberculosis is very rare, but recently, there has been a spurt in the number of reports on pancreatic involvement by tuberculosis. It closely mimics pancreatic cancer, and before the advent of better imaging modalities it was often detected as a histological surprise in patients resected for a presumed pancreatic malignancy. The usual presentation involves abdominal pain, loss of appetite and weight, jaundice which can be associated with cholestasis, fever and night sweats, palpable abdominal lump, and peripheral lymphadenopathy. Computed tomography (CT) of the abdomen is an important tool for evaluation of patients with pancreatic tuberculosis. This CT imaging yields valuable information about the size and nature of tubercular lesions along with the presence of ascites and lymphadenopathy. However, there are no distinctive features on CT that distinguish it from pancreatic carcinoma. Endoscopic ultrasound provides high resolution images of the pancreatic lesions as well as an opportunity to sample these lesions for cytological confirmation. The presence of granulomas is the most common finding on histological/cytological examination with the presence of acid fast bacilli being observed only in minority of patients. As there are no randomized or comparative studies on treatment of pancreatic tuberculosis it is usually treated like other forms of tuberculosis. Excellent cure rates are reported with standard anti tubercular therapy given for 6-12 months.

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Tubercular Pancreatic Abscess Presenting as Fever and Cystic Pancreatic Lesion with Endoscopic Management

Cited by 6 publications

References 5 publications

Pancreatic tuberculosis with acquired immunodeficiency syndrome: A case report and systematic review

Pancreatic tuberculosis with acquired immunodeficiency syndrome: A case report and systematic review

Malignant paraganglioma of the bile duct

Pancreatic tuberculosis

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