Involvement of mediastinal/intra.abdominal lymph nodes, spleen, liver, and left adrenal in presumed isolated pancreatic tuberculosis: An endoscopic ultrasound study

AbstractBackground: Isolated pancreatic tuberculosis is very rare and closely mimics pancreatic cancer. Extra pancreatic involvement is very rare and has been rarely reported. Aim: Study the involvement of mediastinal/intra-abdominal lymph nodes, spleen, liver, and left adrenal in patients of isolated pancreatic tuberculosis using endoscopic ultrasound (EUS). Patients and Methods: Retrospective analysis of the records of 16 patients (12 males; mean age 37.8 ± 9.3 years) with pancreatic tuberculosis seen over last 4 years was done. Results: All 16 patients had a well-defined predominantly hypoechoic mass lesion in the pancreatic head and 7/16 (43%) patient had isolated pancreatic tuberculosis with no lymphadenopathy or extrapancreatic involvement. Nine (57%) patients had involvement of the peripancreatic lymph nodes and 6 (38%), 3 (19%), and 2 (13%) patients had celiac, periportal, and mediastinal nodes involvement, respectively. The diameter of the lymph nodes ranged from 1.2 cm to 2.6 cm with celiac lymph nodes being the largest. The left adrenal had normal morphology on EUS in all patients. The spleen and left lobe of the liver were also normal on EUS. Conclusions: Extra pancreatic involvement is seen in up to one-third of patients with presumed isolated pancreatic tuberculosis with involvement of peri-pancreatic and celiac lymph nodes being the commonest.

Download Full-text

Should a standard lymphadenectomy during pancreatoduodenectomy exclude para-aortic lymph nodes for all cases of resectable pancreatic head cancer? A consensus statement by the Chinese Study Group for Pancreatic Cancer (CSPAC)

International Journal of Oncology ◽

10.3892/ijo.2015.3128 ◽

2015 ◽

Vol 47 (4) ◽

pp. 1512-1516 ◽

Cited By ~ 5

Author(s):

CHEN LIU ◽

RUFU CHEN ◽

YINGTAI CHEN ◽

DELIANG FU ◽

DEFEI HONG ◽

...

Keyword(s):

Pancreatic Cancer ◽

Lymph Nodes ◽

Consensus Statement ◽

Pancreatic Head ◽

Study Group ◽

Head Cancer ◽

Pancreatic Head Cancer ◽

Chinese Study

Download Full-text

A DIAGNOSTIC PITFALL: PANCREATIC TUBERCULOSIS MASQUERADING AS PANCREATIC CARCINOMA

10.36106/ijsr/3022992 ◽

2020 ◽

pp. 80-82

Author(s):

Amitrajit Dasgupta ◽

Indranil Banerjee

Keyword(s):

Weight Loss ◽

Endoscopic Ultrasound ◽

Rare Entity ◽

Ultrasound Guided ◽

Diagnostic Challenge ◽

Diagnostic Pitfall ◽

Pancreatic Tuberculosis ◽

High Incidence ◽

Hypoechoic Mass ◽

Pancreatic Lymph Nodes

Isolated cases of Pancreatic Tuberculosis remains a rare entity even in countries with a high incidence of Tuberculosis. It presents as a hypoechoic mass on ultrasonography and imaging mimicking pancreatic malignancy. Consequently, it represents a diagnostic challenge both clinically (due to a similar array of symptoms) and radiologically. The diagnosis often requires tissue biopsy. The possibility of TB should be considered in the list of differential diagnoses of pancreatic mass and an endoscopic, ultrasound-guided biopsy might help to clinch the diagnosis of this potentially curable disease. Here, we report a case with symptoms of abdominal pain, progressive jaundice, and anorexia and weight loss, diagnosed to be a case of Disseminated Tuberculosis (Pancreatic TB) following Endoscopic Ultrasound guided FNAC of peri-pancreatic lymph nodes.

Download Full-text

Isolated Pancreatic Tuberculosis Mimicking Inoperable Pancreatic Cancer: A Diagnostic Challenge Resolved by Endoscopic Ultrasound-Guided Fine-Needle Aspiration

Canadian Journal of Gastroenterology ◽

10.1155/2013/198715 ◽

2013 ◽

Vol 27 (8) ◽

pp. 445-447 ◽

Cited By ~ 8

Author(s):

Adrien Sportes ◽

Raimi Kpossou ◽

Stephanie Bernardin

Keyword(s):

Pancreatic Cancer ◽

Endoscopic Ultrasound ◽

Fine Needle Aspiration ◽

Needle Aspiration ◽

Ultrasound Guided ◽

Diagnostic Challenge ◽

Fine Needle ◽

Pancreatic Tuberculosis

Download Full-text

Focal IgG4-related autoimmune pancreatitis with distal choledochal adenocarcinoma: a rare case report

BMC Gastroenterology ◽

10.1186/s12876-021-01996-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Han Wang ◽

Lan Yao ◽

Ligang Wang ◽

Xixi Sun ◽

Bin Huang

Keyword(s):

Pancreatic Cancer ◽

Bile Duct ◽

Autoimmune Pancreatitis ◽

Extrahepatic Bile Duct ◽

Pancreatic Head ◽

Research Progress ◽

Distal Common Bile Duct ◽

Radiographic Findings ◽

Pancreatic Biopsy ◽

Pancreatic Involvement

Abstract Background Autoimmune pancreatitis (AIP) is a rare disease that manifests as pancreatic involvement in systemic IgG4-related disease (IgG4-RD), a special type of chronic pancreatitis caused by autoimmune abnormalities. The main imaging manifestations of IgG4-related AIP consist of diffuse or localized pancreatic enlargement and irregular pancreatic duct narrowing. The diagnosis of AIP is challenging because it can present with focal lesions, similar to radiologically bile duct cancer or pancreatic cancer. Case presentation A 55-year-old male patient was admitted with painless jaundice and multiple radiographic findings of pancreatic head mass, as well as intrahepatic and extrahepatic bile duct dilatation. Various imaging methods indicated pancreatic cancer. However, the endoscopic ultrasonography guided fine needle aspiration (EUS-FNA) and a laparoscopic pancreatic biopsy suggested an IgG4-related AIP. After one month, magnetic resonance imaging showed that the lesion had slightly grown. Combined with CA19-9 and other indexes, the possibility of malignancy was high and there were still surgical indications. The pathological analysis following a pancreaticoduodenectomy revealed poorly differentiated adenocarcinoma in the distal common bile duct. Conclusion To date, few reports have described pancreatic or extrapancreatic malignancies in AIP patients, and no association between AIP and bile duct adenocarcinoma has been previously confirmed. This case discuss the differentiation between AIP and malignancy, recent research progress, and the correlation between the two diseases, highlights the importance of carefully evaluating patients with AIP to rule out potential tumors, as well as the critical need for follow up treatment.

Download Full-text