scholarly journals Isolated pancreatic tuberculosis presenting as obstructive jaundice

2021 ◽  
Vol 8 (4) ◽  
pp. 1296
Author(s):  
Muhammad Salman Shafique ◽  
Sayyam Fatima
Keyword(s):  
Obstructive Jaundice ◽  
Pancreatic Head ◽  
Needle Aspiration ◽  
Tuberculosis Patient ◽  
Head Region ◽  
Gradual Improvement ◽  
Pancreatic Tuberculosis ◽  
History Of ◽  
Diagnostic Work ◽  
Anti Tubercular Therapy

A 36-year-old male patient presented in surgical clinic with complaints of abdominal pain and progressively increasing yellowish discoloration of his skin and sclera for last 1 month. He was deeply jaundiced with mild tenderness in epigastric region. He had a strong family history of tuberculosis. Diagnostic work-up revealed obstructive jaundice secondary to pancreatic tuberculosis. Tomographic examination revealed a pancreatic head mass with peripancreatic lymphadenopathy. Endoscopic ultrasound (EUS) showed a mass at pancreatic head region & EUS guided fine needle aspiration revealed tuberculosis. Patient was started on anti-tubercular therapy with gradual improvement of symptoms over the course of treatment.

scholarly journals Tubercular Mastitis in an Elderly Female: A Rare Entity

2021 ◽  
Vol 20 (2) ◽  
pp. 177-180
Author(s):  
Manvendu Jha ◽  
Hakam Singh ◽  
Amulyajeet Kaur
Keyword(s):  
Histopathological Examination ◽  
Needle Aspiration ◽  
Left Breast ◽  
Tuberculosis Patient ◽  
Rare Entity ◽  
Elderly Female ◽  
Key Words Breast ◽  
Breast Tuberculosis ◽  
Needle Aspiration Cytology ◽  
Anti Tubercular Therapy

Introduction: Tuberculosis of the breast is a rare entity, especially in elderly females. Moreover, the disease is overlooked and misdiagnosed as malignancy or pyogenic abscess. Here we report a case of an elderly female who presented with a lump in her left breast which resembled malignancy. Fine needle aspiration cytology followed by histopathological examination confirmed the diagnosis of breast tuberculosis. Patient underwent excision of the lump followed by six months of anti tubercular therapy to which she responded well. Key words: breast; mastitis; tuberculosis

Abdominal Tuberculosis With Pancreatic Head Involvement Mimicking Pancreatic Malignancy in a Young Man: A Case Report

2020 ◽  
Author(s):  
Lie-zhi Wang ◽  
Hao Jiang ◽  
Chong Jin ◽  
Yu Wen ◽  
Heng Zou ◽  
...  
Keyword(s):  
Fine Needle Aspiration Biopsy ◽  
Epigastric Pain ◽  
Pancreatic Head ◽  
Abdominal Tuberculosis ◽  
Needle Aspiration ◽  
Resonance Imaging ◽  
Case Presentation ◽  
Pancreatic Tuberculosis ◽  
Pancreatic Head Carcinoma ◽  
Tomography Scan

Abstract Background：Pancreatic tuberculosis is a rare disease, even in immuocompentent hosts. Abdominal tuberculosis involving the pancreatic head and peripancreatic areas may simulate pancreatic head carcinoma.Case presentation: We herein present the case of a 32-year-old man who was admitted to our hospital for intermittent epigastric pain and weight loss. Computed tomography scan and magnetic resonance imaging revealed a mass in the head of the pancreas.The lesion was initially diagnosed as pancreatic head carcinoma on abdominal imaging. Laparotomy confirmed the diagnosis of pancreatic tuberculosis, while he test for acid-fast bacilli was negative before operation and the patient fully recovered after six month of standard anti-tuberculosis treatment.Conclusions: The present case is reported to emphasize the importance of including pancreatic tuberculosis in the differential diagnosis of pancreatic lesions, under the premise of safety, we recommend endoscopic ultrasound-guided fine needle aspiration biopsy for diagnosis.

scholarly journals Incidence of tuberculosis in enlarged neck nodes, our experience

1970 ◽  
Vol 7 (1) ◽  
pp. 54-58 ◽  
Author(s):  
M Maharjan ◽  
S Hirachan ◽  
PK Kafle ◽  
M Bista ◽  
S Shrestha ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
History Of ◽  
Chest X Ray ◽  
Needle Aspiration Cytology ◽  
Anti Tubercular Therapy ◽  
Tubercular Lymphadenitis

Objectives: To determine the incidence of tuberculous lymphadenitis in enlarged neck nodes. Materials and methods: Continuous prospective study is carried out in the department of otorhinolaryngology head & neck surgery, Kathmandu Medical College, Kathmandu, during two years, from January 2006 to January 2008. The study included a group of 155 patients with cervical lymphadenopathy. Each patient underwent a detail clinical Ear, Nose and Throat (ENT) examination and a battery of investigations which included Fine Needle Aspiration Cytology (FNAC) of the nodes, Montoux's test, blood Erythrocyte Sedimentation Rate (ESR) and chest X-ray. Those patients with tubercular lymphadenitis were referred to Directly Observed Therapy System (DOTS) clinic for anti-tubercular therapy. Others with reactive lymphadenitis were treated with antibiotic and those with metastatic neck nodes were treated accordingly. Results: Of the 155 cases with enlarged neck nodes, 83 (54%) had tubercular lymphadenitis. Fifty two (33%) cases had reactive lymphadenitis and 17 (11%) cases were diagnosed with metastatic neck nodes. Fine needle aspiration cytology was found to be highly effective in the diagnosis of tubercular lymphadenitis with 94% accuracy. Majority of patients were otherwise healthy adults, aged between 8 - 71 years. No difference was observed between male and female in this study. Posterior triangle (PT) nodes were most commonly affected group of nodes accounting for 35 (42%) cases and preauricular region 1 (1%) case being the least commonly affected site. Fifteen (18%) cases presented with abscess formation. Only 42 (50%) cases had family history of tuberculosis but 8 (9%) patients had previous history of various forms of tuberculosis. Twelve (14%) patients had positive chest X-ray findings suggesting of concurrent pulmonary tuberculosis. All the patients were referred to DOTS clinic and were treated with category (CAT) - III anti tubercular therapy (ATT). Others with concurrent pulmonary tuberculosis were treated with CAT I regime. None of the patients required surgical treatment. Conclusion: There is high incidence of tubercular cervical lymphadenitis in patients with enlarged neck nodes in developing countries like Nepal. Involvement of cervical lymphnodes are the most commonly affected group of nodes. Therefore, it is important that otolaryngologists are aware of tuberculosis in the head and neck region. Key words: Tuberculosis, Lymph node, Fine needle aspiration cytology, Lymphadenitis    doi: 10.3126/kumj.v7i1.1766       Kathmandu University Medical Journal (2009), Vol. 7, No. 1, Issue 25, 54-58         

scholarly journals Rifampicin Induced Hyperbilirubinemias: A Case Report.

2019 ◽  
pp. 1-4
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Health Care Team ◽  
Low Grade ◽  
Gradual Improvement ◽  
Learning Programs ◽  
History Of ◽  
Chest X Ray ◽  
Hepatitis C Viruses ◽  
Anti Tubercular Therapy

Abstract Anti-tubercular therapy (ATT) induced hepatitis is a major problem which a physician encounters in his clinical practice. A case of 28-year old female, weighing 45 kg was brought to hospital with the chief complains of low-grade fever for the past two months, cough, shortness of breath and 4-5 kg weight loss in two months. She had no history of hypertension (HTN), diabetes mellitus (DM), pulmonary tuberculosis (PTB). Her Chest X-ray showed right sided bilateral pulmonary TB and sputum acid fast bacilli (AFB) smear was repeatedly positive. Pulmonologist has started Category-I anti-tubercular regimen (Rifampicin, Isoniazid, Pyrazinamide and Ethambutol) under DOTS as per RNTCP guidelines. After 7 days of starting the treatment (DOTS regimen), she noticed yellowish discoloration of sclera, orange discoloration of urine but in spite of this she continued the drug for a further two weeks. Patient was found to be developing hepatotoxicity with the findings of elevated total bilirubin (10.2 mg/dl), conjugated bilirubin (2.5 mg/dl) and unconjugated bilirubin (7.2 mg/dl). Viral markers for hepatitis including hepatitis B viruses (HBsAg), hepatitis C viruses (HCV), human immunodeficiency virus (HIV), were all are non-reactive. Pulmonologist made provisional diagnosis of anti-tubercular drugs (specially rifampicin) induced hyperbilirubinemias. Pulmonologist initially hold Rifampicin and Pyrazinamide, but started Isoniazid, Ethambutol, Ofloxacin, Pyridoxine along with liver enzyme. She showed gradual improvement as bilirubin after one-week had dropped down to 1.2 mg/dl. Rifampicin was added to the regimen and the serum bilirubin checked after 1 week was found 1 mg/dl. Pyrazinamide was added after repeated LFTs showed normal values. Patient continued her drugs and came for review after three months. She was advised to continue and complete the course of anti-tubercular drugs. Since Rifampicin is the most important first line anti-tubercular drug it is very important to restart this drug in order to have a satisfactory response to anti-tubercular therapy. We have reported this case because of its rarity in clinical practice. As a health care team member clinical pharmacist are need to be made aware of these potentially fatal adverse effects associated with anti-tubercular therapy via conduction of quality-based seminars, published medical literature, conferences, learning programs and health care camps.

scholarly journals A Patient with Chronic Lymphocytic Leukemia with Pancreatic Involvement

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Rajesh Essrani ◽  
Matthew J. Sullivan ◽  
Hiral Shah
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Total Bilirubin ◽  
Pancreatic Head ◽  
Needle Aspiration ◽  
Lymphocytic Leukemia ◽  
Pancreatic Involvement ◽  
Laboratory Results ◽  
Night Sweats ◽  
History Of

A 78-year-old female with a past medical history of hypertension, type 2 diabetes mellitus, and chronic lymphocytic leukemia was hospitalized for poor appetite, weight loss, and night sweats. On physical exam, there was no palpable lymphadenopathy, and her abdomen was soft and nondistended. Laboratory results showed a hemoglobin count of 13.3 g/dl, hematocrit 41.3%, white blood cell 68.4 × 103 μL with lymphocytes 92.0%, total bilirubin 0.4 mg/dL, aspartate transaminase 14 U/L, and alanine transaminase 15 U/L. CT of the chest, abdomen, and pelvis showed hypodense lesions within the pancreatic body (1.4 × 1.4 cm) and medial aspect of the pancreatic head (1.2 cm) as well as mild splenomegaly (13 cm craniocaudally). She subsequently underwent endoscopic ultrasound (EUS) with fine needle aspiration (FNA) of the pancreatic mass. Flow cytometry revealed expression of CD5 and CD23, consistent with chronic lymphocytic leukemia.

scholarly journals Pancreatic Tuberculosis mimicking Cystic Neoplasm

2017 ◽  
Vol 20 (1) ◽  
pp. 35-37
Author(s):  
Anamika Jha
Keyword(s):  
Young Patients ◽  
Pancreatic Head ◽  
Young Male ◽  
Cystic Neoplasm ◽  
Histopathological Study ◽  
Head Region ◽  
Pancreatic Involvement ◽  
Pancreatic Masses ◽  
History Of ◽  
Pancreatic Origin

Tuberculosis is endemic in our part of the world and may have uncommon presentations like pancreatic involvement. A young male presented to the OPD with recent history of pain in epigastric region and was subsequently diagnosed with a multi-loculated cystic neoplasm in pancreatic head region on ultrasonography and CT scan. The pancreatic origin was confirmed on surgery while the histopathological study revealed tuberculous nature. This case report highlights the importance of considering tuberculosis in the differential diagnosis in pancreatic masses, especially, with atypical appearances, in young patients or with background predisposing to TB and the need for histological diagnosis.  

RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH CHRONIC PANCREATITIS AND THE RISK OF CANCER AFTER SURGICAL TREATMENT

2018 ◽  
Vol 64 (2) ◽  
pp. 228-233
Author(s):  
Vladimir Lubyanskiy ◽  
Vasiliy Seroshtanov ◽  
Ye. Semenova
Keyword(s):  
Pancreatic Cancer ◽  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Fibrous Tissue ◽  
Pancreatic Head ◽  
Head Region ◽  
Intestinal Anastomoses ◽  
Resection Of The Pancreas ◽  
Risk Of Cancer

The aim: To analyze results of surgical treatment of patients with chronic pancreatitis (CP) and to assess the causes of pancreatic cancer after surgical treatment. Materials and methods: 137 patients had duodenum-preserving resections of the pancreas. Results: In the histological examination of the pancreas it was established that the growth of fibrous tissue was registered in patients with CP., which in 19 (13.8%) almost completely replaced the acinar tissue. In the long term after the operation from 6 months to 2 years in 8 patients (5.8%) pancreatic cancer was detected. Possible causes of tumor origin were analyzed, the value of preservation of ductal hypertension, which affects the state of the duct’s epithelium, was established. The most commonly used for treatment of chronic pancreatitis the Frey surgery removed pancreatic hypertension but in two patients during the operation an insufficient volume of the pancreatic head was reconstructed. In the case of the abandonment of a large array of fibrous tissue, local hypertension was retained in the region of the ductal structures of the head, which led to the transformation of the duct epithelium. An essential factor in the problem of the preservation of pancreatic hypertension were the stenosis of pancreatic intestinal anastomoses, they arose in the long term in 4 operated patients. With stenosis of anastomosis after duodenum-preserving resection both the hypertension factor and the regeneration factor could be realized, which under certain circumstances might be significant. Conclusion: After resection of the pancreas for CP cancer was diagnosed in 5.8% of patients. The main method of preventing the risk of cancer was performing the Frey surgery for CP eliminating pancreatic hypertension in the head region of the pancreas. Diagnosis of stenosis in the late period after resection of the pancreas was an important element in the prevention of recurrence of cancer since a timely reconstructive operation could improve the drainage of duct structures.

scholarly journals Unusual Tissue – Unusual Issue: Pancreatic Heterotopia Presenting as Gastric Outlet Obstruction

2021 ◽  
pp. 338-343
Author(s):  
Thu L. Nguyen ◽  
Shivani Kapur ◽  
Stephen C. Schlack-Haerer ◽  
Grzegorz T. Gurda ◽  
Milan E. Folkers
Keyword(s):  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Needle Aspiration ◽  
Pancreatic Tissue ◽  
Cystic Mass ◽  
Pancreatic Heterotopia ◽  
History Of

Pancreatic heterotopia (PH) is a common, but typically small (<1 cm), incidental and asymptomatic finding; however, PH should be considered even for large and symptomatic upper gastrointestinal masses. A 27-year-old white woman presented with a 3-week history of burning epigastric pain, nausea, early satiety, and constipation. Physical examination revealed epigastric and right upper quadrant tenderness with normal laboratory workup, but imaging revealed a 5-cm, partly cystic mass arising from the gastric antrum with resulting pyloric stenosis and partial gastric outlet obstruction. Endoscopic ultrasound-guided fine needle aspiration revealed PH – an anomalous pancreatic tissue lying in a nonphysiological site. The patient ultimately underwent a resection and recovered uneventfully, with a complete pathologic examination revealing normal exocrine pancreatic tissue (PH type 2) without malignant transformation. We report a case of heterotopic pancreas manifesting as severe gastric outlet obstruction, in addition to a thorough diagnostic workup and surgical follow-up, in a young adult. Differential diagnoses and features that speak to benignity of a large, symptomatic mass lesion (PH in particular) are discussed.

scholarly journals Improvement of the Diagnosis of Isoattenuating Pancreatic Carcinomas by Defining their Characteristics on Contrast Enhanced Computed Tomography and Endosonography with Fine-Needle Aspiration (EUS-FNA)

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 776
Author(s):  
Robert Psar ◽  
Ondrej Urban ◽  
Marie Cerna ◽  
Tomas Rohan ◽  
Martin Hill
Keyword(s):  
Computed Tomography ◽  
Pancreatic Cancer ◽  
Pancreatic Duct ◽  
Fine Needle Aspiration ◽  
Pancreatic Head ◽  
Needle Aspiration ◽  
Characteristic Analysis ◽  
Fine Needle ◽  
Contrast Enhanced ◽  
Secondary Signs

(1) Background. The aim was to define typical features of isoattenuating pancreatic carcinomas on computed tomography (CT) and endosonography and determine the yield of fine-needle aspiration endosonography (EUS-FNA) in their diagnosis. (2) Methods. One hundred and seventy-three patients with pancreatic carcinomas underwent multiphase contrast-enhanced CT followed by EUS-FNA at the time of diagnosis. Secondary signs on CT, size and location on EUS, and the yield of EUS-FNA in isoattenuating and hypoattenuating pancreatic cancer, were evaluated. (3) Results. Isoattenuating pancreatic carcinomas occurred in 12.1% of patients. Secondary signs of isoattenuating pancreatic carcinomas on CT were present in 95.2% cases and included dilatation of the pancreatic duct and/or the common bile duct (85.7%), interruption of the pancreatic duct (76.2%), abnormal pancreatic contour (33.3%), and atrophy of the distal parenchyma (9.5%) Compared to hypoattenuating pancreatic carcinomas, isoattenuating carcinomas were more often localized in the pancreatic head (100% vs. 59.2%; p < 0.001). In ROC (receiver operating characteristic) analysis, the optimal cut-off value for the size of isoattenuating carcinomas on EUS was ≤ 25 mm (AUC = 0.898). The sensitivity of EUS-FNA in confirmation of isoattenuating and hypoattenuating pancreatic cancer were 90.5% and 92.8% (p = 0.886). (4) Conclusions. Isoattenuating pancreatic head carcinoma can be revealed by indirect signs on CT and confirmed with high sensitivity by EUS-FNA.

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