Pancreatic tuberculosis mimicking pancreatic carcinoma - Four case reports and review of the literature
Pancreatic tuberculosis mimicking pancreatic carcinoma - Four case reports and review of the literature
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DOI：
10.1023/a:1018854305652
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发表时间：
1998-02-01
影响因子：
3.1
通讯作者：
Eisa, H
中科院分区：
文献类型：
--
作者：
Rezeig, MA;Fashir, BM;Eisa, H
腹部结核在发展中国家很常见，但胰腺受累极为罕见 (1)。孤立性胰腺结核与恶性病变的鉴别是困难的 (1, 2)。我们报告了四例最初诊断为胰腺癌的胰腺和胰周结核病例。第一位患者出现体重减轻和梗阻性黄疸。第二名患者出现腹痛、发烧和体重减轻，过去曾接受过甲状腺乳头状癌治疗，怀疑已转移至胰腺。第三和第四名患者出现腹痛，但没有发烧或体重减轻。所有影像扫描均显示为胰腺癌。三名患者接受剖腹探查术，结果显示干酪样肉芽肿。第四名患者接受了 CT 引导下的胰腺肿块针吸活检 (FNA)，也显示干酪样肉芽肿。从所有患者获得的组织培养物均生长有抗酸杆菌。标准抗结核治疗使所有患者的病变完全恢复和消退。
Abdominal tuberculosis is common in developing countries but pancreatic involvement is extremely rare (1). Differentiation of isolated pancreatic tuberculosis from a malignant lesion is dif® cult (1, 2). We report four cases of pancreatic and peripancreatic tuberculosis initially diagnosed as pancreatic carcinoma. The® rst patient presented with weight loss and obstructive jaundice. The second patient presented with abdominal pain, fever, and weight loss and had been treated for papillary carcinoma of the thyroid in the past and was suspected to have metastasis to the pancreas. The third and fourth patients presented with abdominal pain without fever or weight loss. All imaging scans favored carcinoma of pancreas. Three patients underwent exploratory laparotomy which showed caseating granulomata. The fourth patient had CT-guided® ne-needle aspiration (FNA) of the pancreatic mass, and this also showed caseating granulomata. Tissue cultures obtained from all patients, grew acid-fast bacilli. Treatment with standard antituberculous therapy resulted in complete recovery and resolution of the lesions in all patients.