Isolated tuberculosis of the pancreas: a report of two cases and review of the literature.
We report two cases of pancreatic tuberculosis. The first patent (who tested positive for HIV) presented with abdominal pain, fever, weight loss, anorexia and tender epigastric lump. The CT scan revealed multiple small abscesses in the pancreas. The second patients, who had no evidence of immunodeficiency, presented with constitutional symptoms and obstructive jaundice. The CT scan revealed a mass in the pancreatic head with peripancreatic lymph nodes and dilatation of the intrahepatic and extrahepatic biliary tree. None of the patients had Mycobacterium tuberculosis infection of the lung or any other organ. Fine-needle aspiration biopsy clinched the diagnosis in both the patients, with caseation necrosis and plenty of acid-fast bacilli in the first patient, and characteristic granulomatous inflammation of the pancreas in the other. The first patient died during the index hospitalization, while the other responded well to antitubercular treatment with improvement in symptoms and radiological clearance of the initial lesions.
Kumar
Rakesh
R
Department of Gastroenterology, GB Pant Hospital, New Delhi 110002.
Kapoor
Dharmesh
D
Singh
Jagdeep
J
Kumar
Nirmal
N
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D044963:Biopsy, Fine-Needle; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*
D000995:Antitubercular Agents