Tuberculous Lymphadenopathy Mimicking Pancreatic Neoplasm
Abdominal tuberculosis (TB) is the sixth most common location of extrapulmonary TB involvement. Because its symptoms and signs are often nonspecific, laboratory and imaging findings mimic other diseases including carcinoma. Therefore, the diagnosis of abdominal TB is challenging. We herein report a...
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Wiley
2012-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2012/579297 |
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| author | Kunikazu Hoshino Shingo Arakaki Daisuke Shibata Tatsuji Maeshiro Akira Hokama Fukunori Kinjo Masayuki Shiraishi Tadashi Nishimaki Jiro Fujita |
| author_facet | Kunikazu Hoshino Shingo Arakaki Daisuke Shibata Tatsuji Maeshiro Akira Hokama Fukunori Kinjo Masayuki Shiraishi Tadashi Nishimaki Jiro Fujita |
| author_sort | Kunikazu Hoshino |
| collection | DOAJ |
| description | Abdominal tuberculosis (TB) is the sixth most common location of extrapulmonary TB involvement. Because its symptoms and signs are often nonspecific, laboratory and imaging findings mimic other diseases including carcinoma. Therefore, the diagnosis of abdominal TB is challenging. We herein report a case of 74-year-old woman who presented with abdominal pain, anorexia, and weight loss. She had been given a diagnosis of pancreatic head carcinoma. Laboratory data was unremarkable except for elevated erythrocyte sedimentation rate, CA125, and sIL-2R. CT scan revealed multiple enlarged peripancreatic lymph nodes and concentric thickening of the ileocecal wall. Colonoscopy demonstrated deformed ileocecal valve and erosions. Histological examination showed epithelioid granulomas. Laparoscopy revealed numerous white tubercles diffusely covering the parietal peritoneum. Histopathological images of peripancreatic lymph node revealed large multiple caseating granulomas surrounded by Langhans_giant cells and epithelioid cells. Polymerase chain reaction and culture of the specimens were positive for Mycobacterium tuberculosis. Tuberculous lymphadenopathy, colitis, and peritonitis were finally diagnosed. She responded well to the antitubercular treatment. |
| format | Article |
| id | doaj-art-60f36a89ab0e45ea829e45864ceabfca |
| institution | OA Journals |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-60f36a89ab0e45ea829e45864ceabfca2025-08-20T02:35:18ZengWileyCase Reports in Medicine1687-96271687-96352012-01-01201210.1155/2012/579297579297Tuberculous Lymphadenopathy Mimicking Pancreatic NeoplasmKunikazu Hoshino0Shingo Arakaki1Daisuke Shibata2Tatsuji Maeshiro3Akira Hokama4Fukunori Kinjo5Masayuki Shiraishi6Tadashi Nishimaki7Jiro Fujita8Department of Infectious, Respiratory, and Digestive Medicine, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, JapanDepartment of Infectious, Respiratory, and Digestive Medicine, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, JapanDepartment of Infectious, Respiratory, and Digestive Medicine, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, JapanDepartment of Infectious, Respiratory, and Digestive Medicine, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, JapanDepartment of Infectious, Respiratory, and Digestive Medicine, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, JapanDepartment of Endoscopy, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, JapanDivision of Digestive and General Surgery, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, JapanDivision of Digestive and General Surgery, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, JapanDepartment of Infectious, Respiratory, and Digestive Medicine, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, JapanAbdominal tuberculosis (TB) is the sixth most common location of extrapulmonary TB involvement. Because its symptoms and signs are often nonspecific, laboratory and imaging findings mimic other diseases including carcinoma. Therefore, the diagnosis of abdominal TB is challenging. We herein report a case of 74-year-old woman who presented with abdominal pain, anorexia, and weight loss. She had been given a diagnosis of pancreatic head carcinoma. Laboratory data was unremarkable except for elevated erythrocyte sedimentation rate, CA125, and sIL-2R. CT scan revealed multiple enlarged peripancreatic lymph nodes and concentric thickening of the ileocecal wall. Colonoscopy demonstrated deformed ileocecal valve and erosions. Histological examination showed epithelioid granulomas. Laparoscopy revealed numerous white tubercles diffusely covering the parietal peritoneum. Histopathological images of peripancreatic lymph node revealed large multiple caseating granulomas surrounded by Langhans_giant cells and epithelioid cells. Polymerase chain reaction and culture of the specimens were positive for Mycobacterium tuberculosis. Tuberculous lymphadenopathy, colitis, and peritonitis were finally diagnosed. She responded well to the antitubercular treatment.http://dx.doi.org/10.1155/2012/579297 |
| spellingShingle | Kunikazu Hoshino Shingo Arakaki Daisuke Shibata Tatsuji Maeshiro Akira Hokama Fukunori Kinjo Masayuki Shiraishi Tadashi Nishimaki Jiro Fujita Tuberculous Lymphadenopathy Mimicking Pancreatic Neoplasm Case Reports in Medicine |
| title | Tuberculous Lymphadenopathy Mimicking Pancreatic Neoplasm |
| title_full | Tuberculous Lymphadenopathy Mimicking Pancreatic Neoplasm |
| title_fullStr | Tuberculous Lymphadenopathy Mimicking Pancreatic Neoplasm |
| title_full_unstemmed | Tuberculous Lymphadenopathy Mimicking Pancreatic Neoplasm |
| title_short | Tuberculous Lymphadenopathy Mimicking Pancreatic Neoplasm |
| title_sort | tuberculous lymphadenopathy mimicking pancreatic neoplasm |
| url | http://dx.doi.org/10.1155/2012/579297 |
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