title: Pancreatic and peripancreatic nodal tuberculosis in immunocompetent patients: report of three cases.
abstract: BACKGROUND
  Pancreatic and peripancreatic tuberculosis in immunocompetent patients is extremely rare. It often mimics pancreatic malignancy. Majority of the cases are diagnosed after an image guided biopsy or after an operation.
  
  
  METHODS
  We report three cases of pancreatic tuberculosis in immunocompetent patients. All three cases were diagnosed without laparotomy. Diagnosis was made by contrast enhanced computed tomography or endoscopic ultrasound guided fine needle aspiration of the peripancreatic mass and all three cases were treated successfully with antituberculous drugs.
  
  
  CONCLUSIONS
  Pancreatic and peripancreatic tuberculosis should be considered in the differential diagnosis of a peripancreatic mass when the patient is young, residing in the endemic zone of tuberculosis or had past history of tuberculosis. Extensive necrosis of peripancreatic lymph nodes with rim enhancement further supports the diagnosis of tuberculosis. Every attempt should be made to diagnose the cases before start of therapy to prevent unnecessary operation.
authors.affiliation: Institute of Postgraduate Medical Education and Research. Kolkata, West Bengal, India. drsukantaray@yahoo.co.in
authors.forename: Sukanta
authors.initials: S
authors.lastname: Ray
authors.forename: Kshaunish
authors.initials: K
authors.lastname: Das
authors.forename: Asit Ranjan
authors.initials: AR
authors.lastname: Mridha
mesh_terms: D000293:Adolescent; D044963:Biopsy, Fine-Needle; D003937:Diagnosis, Differential; D019160:Endosonography; D005260:Female; D006801:Humans; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed; D014376:Tuberculosis / Q000175:diagnosis*