Pancreatic tuberculosis diagnosed with endoscopic ultrasound guided fine needle aspiration.
BACKGROUND
Isolated pancreatic tuberculosis is rare in the Western world. Its clinical presentation often mimics pancreatic malignancy and the diagnosis is usually not suspected or confirmed prior to laparotomy. Endoscopic ultrasound guided fine needle aspiration cytology has proved to be an excellent tool for the cytological diagnosis of pancreatic and peripancreatic masses. However, this technique has not been reported for diagnosing pancreatic or peripancreatic tuberculosis.


METHODS
We describe a 57-year-old South Asian man with pancreatic tuberculosis who presented with fever of undetermined origin and a pancreatic mass on imaging. He was successfully treated with anti-tuberculosis regimen following confirmation of his diagnosis with endoscopic ultrasound guided fine needle aspiration cytology.


CONCLUSIONS
Pancreatic tuberculosis should be suspected in patients having a pancreatic mass, particularly if patient presents with fever and lived in, or traveled to, an area of endemic tuberculosis or exposed to tuberculosis. When the diagnosis is suspected, endoscopic ultrasound guided fine needle aspiration cytology of the pancreatic lesion can confirm the diagnosis and so avoid an unnecessary explorative laparotomy or pancreatic resection.
Ahlawat
Sushil K
SK
Division of Gastroenterology, Department of Medicine, Georgetown University Hospital, School of Medicine, Washington, DC, USA.
Charabaty-Pishvaian
Aline
A
Lewis
James H
JH
Haddad
Nadim G
NG
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D044963:Biopsy, Fine-Needle; D019160:Endosonography; D006801:Humans; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology
D000995:Antitubercular Agents