Isolated pancreatic tuberculosis(TB)remains a rarity despite the high incidence of tuberculosis in many of the African and Asian countries.Presentation as discrete pancreatic mass often masquerades as pancreatic neopl...Isolated pancreatic tuberculosis(TB)remains a rarity despite the high incidence of tuberculosis in many of the African and Asian countries.Presentation as discrete pancreatic mass often masquerades as pancreatic neoplasm and diagnosis may require histology.Extra-hepatic portal hypertension due to splenic vein thrombosis complicating pancreatic TB has been reported in the literature.We report here a case of isolated pancreatic TB with pancreatic head mass mimicking neoplasm with extra-hepatic portal hypertension.The possibility of TB should be considered in the list of differential diagnoses of pancreatic mass and an endoscopic,ultrasound-guided biopsy might help to clinch the diagnosis of this potentially curable disease.展开更多
Endoscopic ultrasound-guided fine-needle biopsy(EUS-FNB)is an excellent investigation to diagnose pancreatic lesions and has shown high accuracy for its use in pathologic diagnosis.Recently,macroscopic on-site evaluat...Endoscopic ultrasound-guided fine-needle biopsy(EUS-FNB)is an excellent investigation to diagnose pancreatic lesions and has shown high accuracy for its use in pathologic diagnosis.Recently,macroscopic on-site evaluation(MOSE)performed by an endoscopist was introduced as an alternative to rapid on-site cytologic evaluation to increase the diagnostic yield of EUS-FNB.The MOSE of the biopsy can estimate the adequacy of the sample directly by the macroscopic evaluation of the core tissue obtained from EUS-FNB.Isolated pancreatic tuberculosis is extremely rare and difficult to diagnose because of its non-specific signs and symptoms.Therefore,this challenging diagnosis is based on endoscopy,imaging,and the bacteriological and histological examination of tissue biopsies.This uncommon presentation of tuberculosis can be revealed as pancreatic mass mimicking cancer.EUS-FNB can be very useful in providing a valuable histopathological diagnosis.A calcified lesion with a cheesy core in MOSE must be suggestive of tuberculosis,leading to the request of the GeneXpert,which can detect Mycobacterium tuberculosis deoxyribonucleic acid and resistance to rifampicin.A decent diagnostic strategy is crucial to prevent unnecessary surgical resection and to supply conservative management with antitubercular therapy.展开更多
文摘Isolated pancreatic tuberculosis(TB)remains a rarity despite the high incidence of tuberculosis in many of the African and Asian countries.Presentation as discrete pancreatic mass often masquerades as pancreatic neoplasm and diagnosis may require histology.Extra-hepatic portal hypertension due to splenic vein thrombosis complicating pancreatic TB has been reported in the literature.We report here a case of isolated pancreatic TB with pancreatic head mass mimicking neoplasm with extra-hepatic portal hypertension.The possibility of TB should be considered in the list of differential diagnoses of pancreatic mass and an endoscopic,ultrasound-guided biopsy might help to clinch the diagnosis of this potentially curable disease.
文摘Endoscopic ultrasound-guided fine-needle biopsy(EUS-FNB)is an excellent investigation to diagnose pancreatic lesions and has shown high accuracy for its use in pathologic diagnosis.Recently,macroscopic on-site evaluation(MOSE)performed by an endoscopist was introduced as an alternative to rapid on-site cytologic evaluation to increase the diagnostic yield of EUS-FNB.The MOSE of the biopsy can estimate the adequacy of the sample directly by the macroscopic evaluation of the core tissue obtained from EUS-FNB.Isolated pancreatic tuberculosis is extremely rare and difficult to diagnose because of its non-specific signs and symptoms.Therefore,this challenging diagnosis is based on endoscopy,imaging,and the bacteriological and histological examination of tissue biopsies.This uncommon presentation of tuberculosis can be revealed as pancreatic mass mimicking cancer.EUS-FNB can be very useful in providing a valuable histopathological diagnosis.A calcified lesion with a cheesy core in MOSE must be suggestive of tuberculosis,leading to the request of the GeneXpert,which can detect Mycobacterium tuberculosis deoxyribonucleic acid and resistance to rifampicin.A decent diagnostic strategy is crucial to prevent unnecessary surgical resection and to supply conservative management with antitubercular therapy.
