Solitary pancreatic tuberculous abscess mimicking prancreatic cystadenocarcinoma: a case report.
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.


METHODS
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.
Liu
Quanda
Q
Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China. liuquanda@sina.com
He
Zhenping
Z
Bie
Ping
P
D000038:Abscess / Q000175:diagnosis*; D000328:Adult; D003536:Cystadenocarcinoma / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D010182:Pancreatic Diseases / Q000175:diagnosis*; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D014383:Tuberculosis, Endocrine / Q000175:diagnosis*