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Case Reports in MedicineVolume 2014 2014, Article ID 410142, 5 pages

Case Report

Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 1185, Miami, FL 33136, USA

Exp.
Therapeutics, Tufts University School of Medicine, 800 Washington Street, Boston, MA 02111, USA

Received 20 January 2014; Revised 31 March 2014; Accepted 1 April 2014; Published 15 April 2014

Academic Editor: Tobias Keck

Copyright © 2014 Ayesha Salahuddin and Muhammad Wasif Saif.
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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 of mycobacterium 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.





Author: Ayesha Salahuddin and Muhammad Wasif Saif

Source: https://www.hindawi.com/



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