Body ImagingPancreatic tuberculosis in an immunocompetent young female mimicking a malignant tumor: A case report and diagnostic radiological investigation☆
Introduction
Tuberculosis remains the leading cause of death among infectious diseases in adults worldwide, with more than 10 million people suffering each year.1 Pulmonary tuberculosis is the most common type of tuberculosis; however, some cases have extrapulmonary lesions, such as lymphadenitis, pleuritis, and rarely urinary, intestinal tract, or skeletal lesion, which are difficult to diagnose.2 Here, we report a case of pancreatic tuberculosis (PTB) in an immunocompetent young female mimicking a malignant tumor diagnosed by endoscopic ultrasound-guided fine needle aspiration and biopsy (EUS-FNAB).
Section snippets
Case description
A 19-year-old Japanese female with no prior medical history visited other hospitals with abdominal epigastralgia and appetite loss lasting 2 months. As the symptoms did not improve with nizatidine and scopolamine, she was referred to another hospital. Although an upper gastrointestinal endoscopy was normal, a solid mass in the pancreatic head was observed with enhanced abdominal computed tomography; therefore, she was admitted to our hospital for further examination and treatment. Vital signs
Discussion
Tuberculosis remains the leading cause of death from infectious disease among adults worldwide.1 Some cases, especially extrapulmonary tuberculosis, are difficult to diagnose. Notably, extrapulmonary tuberculosis occurs in 18.7% of all tuberculosis patients, and the infection sites are mainly lymphatic (40.4%), pleural (19.8%), bone or joint (11.3%), genitourinary (6.5%), meningeal (5.4%), or peritoneal (4.9%).2 Although some cases with PTB have been reported,3., 4. it is recognized as a rare
Consent for publication
Written informed consent was obtained from the patient for the publication of this report.
Authorship statement
All authors meet the ICMJE authorship criteria.
Declaration of competing interest
None.
Acknowledgment
The authors are grateful to the entire staff of our hospital who gave us valuable advice on the diagnostics and treatments.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Author contributions
TM and KT drafted the manuscript. SI was responsible for the clinical management and therapy. YN performed the microbiological examination. TM, RS, and KM performed the radiological analysis. MM contributed to the pathological analysis. SK was responsible for the clinical data of mass-forming pancreatic diseases. All authors read and approved the final manuscript.
Ethics approval
The Jikei University School of Medicine Ethics Committee approved this report (No. 33-086 (10698)), June 7, 2021. The procedures were in accordance with the ethical standards of the Helsinki Declaration of the World Medical Association.
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Cited by (0)
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Precis: Pancreatic tuberculosis (PTB) can mimick a malignant tumor. PTB is hard to differentiate from other pancreatic diseases by standard MRI. MRI apparent diffusion coefficient values provide valuable insights for diagnostic.
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These authors contributed equally.