Pancreatic Tuberculosis or Autoimmune Pancreatitis
Introduction. Isolated pancreatic and peripancreatic tuberculosis is a challenging diagnosis due to its rarity and variable presentation. Pancreatic tuberculosis can mimic pancreatic carcinoma. Similarly, autoimmune pancreatitis can appear as a focal lesion resembling pancreatic malignancy. Endoscop...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2014/410142 |
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| author | Ayesha Salahuddin Muhammad Wasif Saif |
| author_facet | Ayesha Salahuddin Muhammad Wasif Saif |
| author_sort | Ayesha Salahuddin |
| collection | DOAJ |
| description | Introduction. Isolated pancreatic and peripancreatic tuberculosis is a challenging diagnosis due to its rarity and variable presentation. Pancreatic tuberculosis can mimic pancreatic carcinoma. Similarly, autoimmune pancreatitis can appear as a focal lesion resembling pancreatic malignancy. Endoscopic ultrasound-guided fine needle aspiration provides an effective tool for differentiating between benign and malignant pancreatic lesions. The immune processes involved in immunoglobulin G4 related systemic diseases and tuberculosis appear to have some similarities. Case Report. We report a case of a 59-year-old Southeast Asian male who presented with fever, weight loss, and obstructive jaundice. CT scan revealed pancreatic mass and enlarged peripancreatic lymph nodes. Endoscopic ultrasound-guided fine needle aspiration confirmed the presence of mycobacterium tuberculosis. Patient also had high immunoglobulin G4 levels suggestive of autoimmune pancreatitis. He was started on antituberculosis medications and steroids. Clinically, he responded to treatment. Follow-up imaging showed findings suggestive of chronic pancreatitis. Discussion. Pancreatic tuberculosis and autoimmune pancreatitis can mimic pancreatic malignancy. Accurate diagnosis is imperative as unnecessary surgical intervention can be avoided. Endoscopic ultrasound-guided fine needle aspiration seems to be the diagnostic test of choice for pancreatic masses. Long-term follow-up is warranted in cases of chronic pancreatitis. |
| format | Article |
| id | doaj-art-be40b3ac8ae54148af2e80db6ec5e9e5 |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-be40b3ac8ae54148af2e80db6ec5e9e52025-02-03T01:02:57ZengWileyCase Reports in Medicine1687-96271687-96352014-01-01201410.1155/2014/410142410142Pancreatic Tuberculosis or Autoimmune PancreatitisAyesha Salahuddin0Muhammad Wasif Saif1Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 1185, Miami, FL 33136, USAExp. Therapeutics, Tufts University School of Medicine, 800 Washington Street, Boston, MA 02111, USAIntroduction. Isolated pancreatic and peripancreatic tuberculosis is a challenging diagnosis due to its rarity and variable presentation. Pancreatic tuberculosis can mimic pancreatic carcinoma. Similarly, autoimmune pancreatitis can appear as a focal lesion resembling pancreatic malignancy. Endoscopic ultrasound-guided fine needle aspiration provides an effective tool for differentiating between benign and malignant pancreatic lesions. The immune processes involved in immunoglobulin G4 related systemic diseases and tuberculosis appear to have some similarities. Case Report. We report a case of a 59-year-old Southeast Asian male who presented with fever, weight loss, and obstructive jaundice. CT scan revealed pancreatic mass and enlarged peripancreatic lymph nodes. Endoscopic ultrasound-guided fine needle aspiration confirmed the presence of mycobacterium tuberculosis. Patient also had high immunoglobulin G4 levels suggestive of autoimmune pancreatitis. He was started on antituberculosis medications and steroids. Clinically, he responded to treatment. Follow-up imaging showed findings suggestive of chronic pancreatitis. Discussion. Pancreatic tuberculosis and autoimmune pancreatitis can mimic pancreatic malignancy. Accurate diagnosis is imperative as unnecessary surgical intervention can be avoided. Endoscopic ultrasound-guided fine needle aspiration seems to be the diagnostic test of choice for pancreatic masses. Long-term follow-up is warranted in cases of chronic pancreatitis.http://dx.doi.org/10.1155/2014/410142 |
| spellingShingle | Ayesha Salahuddin Muhammad Wasif Saif Pancreatic Tuberculosis or Autoimmune Pancreatitis Case Reports in Medicine |
| title | Pancreatic Tuberculosis or Autoimmune Pancreatitis |
| title_full | Pancreatic Tuberculosis or Autoimmune Pancreatitis |
| title_fullStr | Pancreatic Tuberculosis or Autoimmune Pancreatitis |
| title_full_unstemmed | Pancreatic Tuberculosis or Autoimmune Pancreatitis |
| title_short | Pancreatic Tuberculosis or Autoimmune Pancreatitis |
| title_sort | pancreatic tuberculosis or autoimmune pancreatitis |
| url | http://dx.doi.org/10.1155/2014/410142 |
| work_keys_str_mv | AT ayeshasalahuddin pancreatictuberculosisorautoimmunepancreatitis AT muhammadwasifsaif pancreatictuberculosisorautoimmunepancreatitis |