1. Home
  2. Vol 53, No 4 (2021)
  3. Maulahela

Peripancreatic Tuberculosis Lymphadenopathy: The Role of Endoscopic Ultrasound for Diagnosis

Hasan Maulahela, Achmad Fauzi

Abstract


Pancreatic and peripancreatic tuberculosis is a rare abdominal tuberculosis. Diagnosis for pancreatic tuberculosis can be challenging. Conventional imaging tools may show mass or malignancy in the pancreas. Endoscopic ultrasound (EUS) is an excellent tools for evaluating pancreas and peri pancreas region. It also allows us to obtain tissue sample for cytology and histopathology. Here we present a case of peripancreatic tuberculosis lymphadenopathy that mimic pancreatic mass. His symptoms were also nonspecific (weight loss, epigastric pain, and irregular fever). From EUS evaluation we found that there was no mass but multiple lymphadenopathy around the pancreas and then performed FNA. The result of the cytology was granuloma inflammation and caseous necrosis which is compatible with tuberculosis infection. From this case illustration we conclude that EUS is an important diagnostic tool for pancreatic lesion to avoid unnecessary surgery.

Keywords


Pancreas; tuberculosis; lymphadenopathy; endoscopic ultrasound

References


Bhansali SK. Abdominal tuberculosis. Experiences with 300 cases. Am J Gastroenterol. 1977;67(4):324-37.

Franco-Paredes C, Leonard M, Jurado R, Blumberg HM, Smith RM. Tuberculosis of the pancreas: report of two cases and review of the literature. Am J Med Sci. 2002;323(1):54-8.

Rao RN, Pandey R, Rana MK, Rai P, Gupta A. Pancreatic and peripancreatic tuberculosis presenting as hypoechoic mass and malignancy diagnosed by ultrasound-guided fine-needle aspiration cytology. Journal of Cytology / Indian Academy of Cytologists. 2013;30(2):130-5.

Chen CH, Yang CC, Yeh YH, Yang JC, Chou DA. Pancreatic tuberculosis with obstructive jaundice--a case report. Am J Gastroenterol. 1999;94(9):2534-6.

Song TJ, Lee SS, Park DH, et al. Yield of EUS-guided FNA on the diagnosis of pancreatic/peripancreatic tuberculosis. Gastrointestinal Endoscopy. 2009;69(3 Pt 1):484-91.

Chang KJ, Nguyen P, Erickson RA, Durbin TE, Katz KD. The clinical utility of endoscopic ultrasound-guided fine-needle aspiration in the diagnosis and staging of pancreatic carcinoma. Gastrointestinal Endoscopy. 1997;45(5):387-93.

Best LM, Rawji V, Pereira SP, Davidson BR, Gurusamy KS. Imaging modalities for characterising focal pancreatic lesions. Cochrane Database Syst Rev. 2017;4:Cd010213.

Aljafari AS, Khalil EA, Elsiddig KE, et al. Diagnosis of tuberculous lymphadenitis by FNAC, microbiological methods and PCR: a comparative study. Cytopathol. 2004;15(1):44-8.

Majeed MM, Bukhari MH. Evaluation for granulomatous inflammation on fine needle aspiration cytology using special stains. Pathol Res Int. 2011;2011.


Full Text: PDF

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.