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Isolated pancreatic tuberculosis.

T Yokoyama1, S Miyagawa, T Noike

  • 1Shinshu University School of Medicine, The First Department of Surgery, Matsumoto, Nagano, Japan.

Hepato-Gastroenterology
|August 3, 1999
PubMed
Summary
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Tuberculosis of the pancreas was diagnosed in a 65-year-old man using Mycobacterium tuberculosis DNA detection via polymerase chain reaction (PCR) assay. This enabled prompt antituberculosis treatment, leading to an uneventful recovery.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Oncology

Background:

  • Pancreatic masses are frequently malignant, posing diagnostic challenges.
  • Tuberculosis (TB) can manifest in unusual extrapulmonary sites, including the pancreas.
  • Distinguishing pancreatic TB from pancreatic cancer preoperatively is difficult.

Observation:

  • A 65-year-old man presented with findings highly suggestive of a malignant pancreatic tumor.
  • Preoperative and intraoperative assessments, excluding helical computed tomography, indicated malignancy.
  • Histopathology revealed caseating granulomatous inflammation, but special stains and cultures were negative for tuberculosis.

Findings:

  • Polymerase chain reaction (PCR) assay detected Mycobacterium tuberculosis DNA in the pancreatic resection specimen.

Related Experiment Videos

  • This molecular detection confirmed a diagnosis of pancreatic tuberculosis.
  • PCR provided a definitive diagnosis when conventional methods failed.

    • Implications:

    • Early and accurate diagnosis of pancreatic tuberculosis is crucial.
    • Molecular diagnostic tools like PCR are vital for identifying rare extrapulmonary TB presentations.
    • Prompt initiation of antituberculosis treatment leads to favorable patient outcomes.