Pancreatic Tuberculosis: A Case Report

JNGMC Pub Date : 2023-09-01 DOI:10.3126/jngmc.v21i1.58303
Richa Shrestha, Anup Sharma, Pooja Baidya, Milan Adhikari
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 Case presentation: A 71 year female presented with abdominal pain with no history of pulmonary tuberculosis. Radiological studies suggested pancreatic carcinoma. Laparotomy was performed and Whipple’s pancreatoduodenctomy specimen was sent to histopathology department along with regional lymphnodes. On gross examination, a mass was noted in uncinate process. Histopathological examination revealed chronic inflammatory granulomatous reaction with Langhan’s giant cells and areas of caseous necrosis. The Ziehl Neelsen (ZN) stain confirmed the presence of acid-fast bacilli diagnosing pancreatic tuberculosis.
 Conclusion: Tuberculosis should be considered as one of the differential diagnosis of pancreatic masses, especially in immunocompromised patients, as the outcome to antituberculosis treatment is very favorable.","PeriodicalId":476221,"journal":{"name":"JNGMC","volume":"127 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JNGMC","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3126/jngmc.v21i1.58303","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract

Introduction: Pancreatic tuberculosis is a rare condition even in countries with high tuberculosis prevalence. It can mimic pancreatic carcinoma in symptoms and radiological studied. Extrapulmonary tuberculosis is common in organs like liver, bowel, spleen, peritoneum and mesenteric lymphnodes than pancreas which is suggestive to have protective role because of its secretions. Case presentation: A 71 year female presented with abdominal pain with no history of pulmonary tuberculosis. Radiological studies suggested pancreatic carcinoma. Laparotomy was performed and Whipple’s pancreatoduodenctomy specimen was sent to histopathology department along with regional lymphnodes. On gross examination, a mass was noted in uncinate process. Histopathological examination revealed chronic inflammatory granulomatous reaction with Langhan’s giant cells and areas of caseous necrosis. The Ziehl Neelsen (ZN) stain confirmed the presence of acid-fast bacilli diagnosing pancreatic tuberculosis. Conclusion: Tuberculosis should be considered as one of the differential diagnosis of pancreatic masses, especially in immunocompromised patients, as the outcome to antituberculosis treatment is very favorable.
胰腺结核1例报告
胰腺结核是一种罕见的疾病,即使在结核病高流行的国家。在症状和影像学研究上与胰腺癌相似。肺外结核多见于肝、肠、脾、腹膜、肠系膜淋巴结等脏器,较胰腺多见,其分泌物提示具有保护作用。 病例介绍:71岁女性,腹痛,无肺结核病史。放射学检查提示胰腺癌。开腹手术,胰十二指肠Whipple切除标本及局部淋巴结送组织病理学。大体检查,钩突处可见肿块。组织病理学检查显示慢性炎性肉芽肿反应,伴有朗汉巨细胞和干酪样坏死区。Ziehl - Neelsen (ZN)染色证实存在诊断胰腺结核的抗酸杆菌。 结论:抗结核治疗效果良好,应将结核作为胰腺肿块的鉴别诊断之一,尤其是免疫功能低下患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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