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Pancreatic tuberculosis or autoimmune pancreatitis
Ayesha Salahuddin1, Muhammad Wasif Saif2
1Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 1185, Miami, FL 33136, USA.
Case Reports in Medicine
|May 20, 2014
Summary
Diagnosing pancreatic tuberculosis can be difficult as it mimics pancreatic cancer and autoimmune pancreatitis. Endoscopic ultrasound-guided fine needle aspiration is key for accurate diagnosis, avoiding unnecessary surgery.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Oncology
Background:
- Pancreatic tuberculosis is rare and presents variably, often mimicking pancreatic cancer.
- Autoimmune pancreatitis can also present as a focal lesion resembling pancreatic malignancy.
- Differentiating these conditions is crucial to avoid misdiagnosis and inappropriate treatment.
Purpose of the Study:
- To highlight the diagnostic challenges in differentiating pancreatic tuberculosis from other pancreatic pathologies.
- To emphasize the role of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in diagnosis.
- To present a case where pancreatic tuberculosis mimicked autoimmune pancreatitis and malignancy.
Main Methods:
- A case report of a 59-year-old male with obstructive jaundice, fever, and weight loss.
- CT scan revealed a pancreatic mass and enlarged lymph nodes.
- Diagnosis was confirmed by EUS-FNA, identifying Mycobacterium tuberculosis.
Main Results:
- The patient presented with symptoms and imaging findings suggestive of pancreatic malignancy.
- EUS-FNA confirmed pancreatic tuberculosis.
- High immunoglobulin G4 levels were noted, initially suggesting autoimmune pancreatitis.
Conclusions:
- Pancreatic tuberculosis and autoimmune pancreatitis can present similarly to pancreatic cancer, necessitating accurate diagnosis.
- EUS-FNA is the preferred diagnostic modality for pancreatic masses.
- Prompt diagnosis and treatment of pancreatic tuberculosis can prevent unnecessary surgical interventions.
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