Pancreatic tuberculosis diagnosed with endoscopic ultrasound guided fine needle aspiration.
Pancreatic tuberculosis diagnosed with endoscopic ultrasound guided fine needle aspiration.
复制标题
超声内镜引导下细针抽吸诊断胰腺结核。
作者：
S. Ahlawat;Aline Charabaty;J. Lewis;N. Haddad
上下文
孤立性胰腺结核在西方世界很少见。它的临床表现往往模仿胰腺恶性肿瘤和诊断通常是不怀疑或证实剖腹手术前。内镜超声引导下细针穿刺细胞学检查已被证明是胰腺和胰周肿块细胞学诊断的一种很好的工具。然而，这项技术尚未报道用于诊断胰腺或胰周结核。
病例报告
我们报告一位57岁的南亚男性胰脏结核病人，临床表现为不明原因的发热及影像学上的胰脏肿块。经内视镜超音波导引细针穿刺细胞学检查确认诊断后，以抗结核疗法成功治疗。
结论
胰腺结核应怀疑患者有胰腺肿块，特别是如果患者出现发热，生活在或旅行到结核病流行区或暴露于结核病。当怀疑诊断时，内镜超声引导下胰腺病变细针穿刺细胞学检查可以确诊，从而避免不必要的剖腹探查或胰腺切除术。
CONTEXT
Isolated pancreatic tuberculosis is rare in the Western world. Its clinical presentation often mimics pancreatic malignancy and the diagnosis is usually not suspected or confirmed prior to laparotomy. Endoscopic ultrasound guided fine needle aspiration cytology has proved to be an excellent tool for the cytological diagnosis of pancreatic and peripancreatic masses. However, this technique has not been reported for diagnosing pancreatic or peripancreatic tuberculosis.
CASE REPORT
We describe a 57-year-old South Asian man with pancreatic tuberculosis who presented with fever of undetermined origin and a pancreatic mass on imaging. He was successfully treated with anti-tuberculosis regimen following confirmation of his diagnosis with endoscopic ultrasound guided fine needle aspiration cytology.
CONCLUSIONS
Pancreatic tuberculosis should be suspected in patients having a pancreatic mass, particularly if patient presents with fever and lived in, or traveled to, an area of endemic tuberculosis or exposed to tuberculosis. When the diagnosis is suspected, endoscopic ultrasound guided fine needle aspiration cytology of the pancreatic lesion can confirm the diagnosis and so avoid an unnecessary explorative laparotomy or pancreatic resection.