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Tuberculous cold abscess simulating pancreatic pseudocyst.

K Karia1, S K Mathur

  • 1Department of Surgical Gastroenterology, H. P. B. Surgery and Liver Transplantation, Bombay Hospital and Medical Research Centre, Mumbai - 400 020, India.

Journal of Postgraduate Medicine
|June 16, 2000
PubMed
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Tuberculosis can affect lymph nodes near the pancreas, appearing similar to pancreatic pseudocysts. Surgical exploration revealed a tuberculous cold abscess, which resolved with antituberculous medication and drainage.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Surgical Pathology

Background:

  • Pancreatic pseudocysts are common complications of pancreatitis.
  • Tuberculosis can present with atypical manifestations, including abdominal abscesses.
  • Accurate diagnosis is crucial for effective treatment of pancreatic pathologies.

Observation:

  • A patient presented with symptoms suggestive of a pancreatic pseudocyst.
  • Imaging revealed a peripancreatic mass.
  • Surgical exploration was performed for diagnosis and management.

Findings:

  • The peripancreatic mass was identified as a tuberculous cold abscess, not a pancreatic pseudocyst.
  • Microscopic examination confirmed caseating granulomas, characteristic of tuberculosis.

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  • Cultures were positive for Mycobacterium tuberculosis.
  • Implications:

    • Peripancreatic lymph node tuberculosis should be considered in the differential diagnosis of pancreatic pseudocysts, especially in endemic areas.
    • Prompt diagnosis and initiation of antituberculous therapy are essential for favorable outcomes.
    • This case highlights the importance of considering infectious etiologies in pancreatic lesions that mimic neoplastic or cystic conditions.