Clinics in diagnostic imaging (117).
A 76-year-old woman presented with a five-day history of fever and abdominal pain. Her urine culture grew Candida albicans. She was treated with intravenous antibiotics, as having a urinary tract infection, but her fever persisted. Computed tomography of the abdomen showed a cystic mass at the pancreatic head and uncinate process with peripancreatic lymph nodes. Given the patientos high operative risk and her clinical picture favouring sepsis, endoscopic ultrasonographical fine-needle aspiration (EUS-FNA) which was performed, revealed pus with acid-fast bacilli seen in the cell block material. The patient was started on antituberculous medication with rapid improvement of symptoms. Pancreatic tuberculosis (TB) is rare and can mimic pancreatic carcinoma both clinically and radiologically. Histological diagnosis is crucial before administration of appropriate therapy. The usefulness of EUS-FNA and its pitfalls, as well as the other radiological modalities for the evaluation and assessment of pancreatic TB are discussed.
Teo
L L S
LL
Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Road, Main Building Level 2, Singapore 119074. lslteo@yahoo.com
Venkatesh
S K
SK
Ho
K Y
KY
D015746:Abdominal Pain / Q000000981:diagnostic imaging* / Q000382:microbiology; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D044963:Biopsy, Fine-Needle; D001799:Blood Sedimentation; D005260:Female; D005334:Fever; D006801:Humans; D009336:Necrosis / Q000000981:diagnostic imaging / Q000382:microbiology; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000473:pathology; D010182:Pancreatic Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000382:microbiology; D011859:Radiography; D014385:Tuberculosis, Gastrointestinal / Q000000981:diagnostic imaging* / Q000188:drug therapy
D000900:Anti-Bacterial Agents