scholarly journals Pancreatic Tuberculosis or Autoimmune Pancreatitis

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Ayesha Salahuddin ◽  
Muhammad Wasif Saif
Keyword(s):  
Chronic Pancreatitis ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Autoimmune Pancreatitis ◽  
Needle Aspiration ◽  
Ultrasound Guided ◽  
Immunoglobulin G4 ◽  
Fine Needle ◽  
Pancreatic Tuberculosis

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 ofmycobacterium 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.

The Yield of Endoscopic Ultrasound-Guided Fine Needle Aspiration with a 19-Gauge Needle for the Diagnosis of Autoimmune Pancreatitis

2009 ◽  
Vol 69 (5) ◽  
pp. AB129-AB130
Author(s):  
Takuji Iwashita ◽  
Ichiro Yasuda ◽  
Shinpei Doi ◽  
Masanori Nakashima ◽  
Tuyoshi Mukai ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Autoimmune Pancreatitis ◽  
Needle Aspiration ◽  
Ultrasound Guided ◽  
Fine Needle

scholarly journals Performance of endoscopic ultrasound-guided fine needle aspiration in diagnosing pancreatic neuroendocrine tumors

CytoJournal ◽  
2013 ◽  
Vol 10 ◽  
pp. 10 ◽  
Author(s):  
Jane Bernstein ◽  
Berrin Ustun ◽  
Ahmed Alomari ◽  
Fang Bao ◽  
Harry R. Aslanian ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
False Negative ◽  
Needle Aspiration ◽  
Cystic Neoplasm ◽  
Pancreatic Neuroendocrine Tumors ◽  
Ultrasound Guided ◽  
Fine Needle

Background: Pancreatic neuroendocrine tumors (PNETs) are rare tumors of the pancreas, which are increasingly diagnosed by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). In this retrospective study, we assessed the performance of EUS-FNA in diagnosing PNETs. Materials and Methods: We identified 48 cases of surgically resected PNETs in which pre-operative EUS-FNA was performed. The clinical features, cytological diagnoses, and surgical follow-up were retrospectively reviewed. The diagnostic performance of EUS-FNA was analyzed as compared to the diagnosis in the follow-up. The cases with discrepancies between cytological diagnosis and surgical follow-up were analyzed and diagnostic pitfalls in discrepant cases were discussed. Results: The patients were 20 male and 28 female with ages ranging from 15 years to 81 years (mean 57 years). The tumors were solid and cystic in 41 and 7 cases, respectively, with sizes ranging from 0.5 cm to 11 cm (mean 2.7 cm). Based on cytomorphologic features and adjunct immunocytochemistry results, when performed, 38 patients (79%) were diagnosed with PNET, while a diagnosis of suspicious for PNET or a diagnosis of neoplasm with differential diagnosis including PNET was rendered in the 3 patients (6%). One case was diagnosed as mucinous cystic neoplasm (2%). The remaining 6 patients (13%) had non-diagnostic, negative or atypical diagnosis. Conclusions: Our data demonstrated that EUS-FNA has a relatively high sensitivity for diagnosing PNETs. Lack of additional materials for immunocytochemical studies could lead to a less definite diagnosis. Non-diagnostic or false negative FNA diagnosis can be seen in a limited number of cases, especially in those small sized tumors.

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