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Isolated Pancreatic Tuberculosis Mimicking Pancreatic Cancer: A Diagnostic Challenge
Abhishek Bhurwal1, Muhammad Masoodul Haq1, Sunil Sapru1
1Department of Internal Medicine, Saint Barnabas Medical Center, RWJBarnabas Health, West Orange, NJ, USA.
Case Reports in Gastrointestinal Medicine
|June 1, 2018
Summary
Isolated pancreatic tuberculosis, though rare, can mimic pancreatic cancer. Early diagnosis via endoscopic ultrasound with fine-needle aspiration and prompt antituberculosis therapy ensures successful treatment and avoids surgery.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Oncology
Background:
- Abdominal tuberculosis is a common extrapulmonary manifestation.
- Isolated pancreatic tuberculosis is exceptionally rare, even in endemic regions.
Observation:
- A case of isolated pancreatic tuberculosis presented as a pancreatic mass.
- Symptoms included persistent abdominal pain and jaundice.
- The mass was clinically and radiologically indistinguishable from malignant pancreatic tumors.
Findings:
- Endoscopic ultrasound with fine-needle aspiration (EUS-FNA) confirmed the diagnosis.
- Acid-fast bacilli were identified in tissue samples.
- Mycobacterium tuberculosis grew in cultures, confirming tuberculosis.
Implications:
- Early diagnosis and conservative management with antituberculosis therapy (ATT) are crucial.
- Prompt treatment can prevent unnecessary surgery and associated morbidity.
- Accurate diagnosis is vital due to differing prognoses and treatments for tuberculosis versus malignancy.
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