Solitary pancreatic tuberculous abscess mimicking prancreatic cystadenocarcinoma: a case report
Solitary pancreatic tuberculous abscess mimicking prancreatic cystadenocarcinoma: a case report
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DOI：
10.1186/1471-230x-3-1
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发表时间：
2003-01-10
影响因子：
2.4
通讯作者：
Bie, P
中科院分区：
文献类型：
--
作者：
Liu, QD;He, ZP;Bie, P
背景：胰腺结核发病极为罕见，常被误诊为胰腺肿瘤。该实体的非手术诊断仍然是一个挑战。病例介绍：一名 33 岁男性，有 6 个月的间歇性右上腹模糊疼痛和体重减轻病史，发现孤立的胰腺囊性肿块，诊断为胰腺囊腺癌。胸部X光片和体检未发现异常。腹部超声（US）检查显示胰头有一个 6.6 cm x 4.4 cm 的不规则低回声病变，彩色多普勒血流成像未显示肿块内有血流。超声引导下经皮细针穿刺活检未能获得病变病理证据，剖腹探查及切开活检发现胰头干酪样脓肿，无结核性肉芽肿典型改变，但抗酸染色阳性。结论：胰腺局灶性病变的鉴别诊断应考虑胰腺结核，尤其是发展中国家的年轻人。
Background: The incidence of pancreatic tuberculosis is extremely rare, and it frequently misdiagnosed as pancreatic neoplasms. The nonsurgical diagnosis of this entity continues to be a challenge.Case presentation: A 33 year old male with six-month history of intermittent right epigastric vague pain and weight lost had found a solitary pancreatic cystic mass and diagnosed as pancreatic cystadenocarcinoma. The chest X-ray film and physical examination revealed no abnormalities. Abdominal ultrasound (US) examination showed an irregular hypoechoic lesion of 6.6 cm x 4.4 cm in the head of pancreas, and color Doppler flow imaging did not demonstrate blood stream in the mass. The attempts to obtain pathological evidence of the lesion by US-guided percutaneous fine needle aspiration failed, an exploratory laparotomy and incisional biopsy revealed a caseous abscess of the head of pancreas without typical changes of tuberculous granuloma, but acid-fast stain was positive.Conclusions: Pancreatic tuberculosis should be considered in the differential diagnosis of focal pancreatic lesions, especially for young people in developing countries.