Pancreatic pseudotumor due to peripancreatic lymphadenitis: case report and literature review

Abstract

The pancreas has exocrine and endocrine glandular tissue, the latter accounting for only 1-2% of the gland. Pancreatic disorders are common but difficult to diagnose due to their anatomical location and vague symptoms. Pancreatic pseudotumors are enlarged pancreas without neoplasia and can be mistakenly diagnosed as malignant, complicating treatment. One study demonstrated that 9.2% of pancreatic resections suspected of malignancy were benign. In the clinical case presented, a 35-year-old male patient presented with severe abdominal pain, jaundice, weight loss, as well as fever, nausea, and vomiting. Laboratory tests showed significant changes in liver enzymes, bilirubin, and blood count. The differential diagnosis included lymphoma, tuberculosis, and other pathologies. Laparotomy revealed peripancreatic lymph nodes with caseous necrosis, which were confirmed as tuberculosis. Pancreatic tuberculosis is rare and can be confused with neoplasms due to similar symptoms. Accurate diagnosis requires a high degree of suspicion and methods such as image-guided biopsy. Treatment involves the use of tuberculostatics. In endemic regions, tuberculosis should always be considered in cases of peripancreatic lesions.