Peripancreatic tuberculous lymphadenitis mimicking pancreatic cancer

Peripankreatik lenf nodlarının izole tutulumu, tüberkülozun çok nadir bulgularından biridir. Bu yazıda, blier obstrüksiyona neden olan pankreatik kitle seklinde presente olan bir tüberküloz lenfadenitin BT (Bilgisayarlı Tomografi) bulgularını tanımladık. Çok nadir olmasında rağmen, tüberküloz lenfadeniti bilier obstrüktif semptomlarla gelen genç erişkin hastalarda, özellikle dünyanın endemik bölgelerinde, ayırıcı tanıda akılda tutulmalıdır.

Pankreas kanserini taklit eden peripankreatik tüberküloz lenfadeniti

Isolated involvement of peripancreatic lymph nodes is a very rare manifestation of tuberculosis. We report the computed tomography (CT) findings of tuberculous lymphadenitis presenting as a pancreatic mass causing biliary obstruction. Although very rare, tuberculosis lymphadenitis should be considered in young adults presenting with biliary obstructive symptoms, especially in endemic parts of the world.

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  • 1. Hashimato M, Koyama H, Noiei T, Shiayama K Kitamura N. Abdominal tuberculoma mimicking a pancreatic neoplasm: Report of a ease. Surg Today 1995; 25: 365-368,
  • 2. Manohar A, Simjee AE, Haffejee AA, Fettengel KE: Symptoms and investigative findings in 145 patients with tuberculous peritonitis diagnosed by peritoneoscopy and biopsy over a 5-year period. Gut 1990; 31: 1130-1132.
  • 3. Bhansali SK Abdominal tuberculosis: experiences with 300 cases. Am J Gastroenterol 1977; 67: 324337.
  • 4. Hulnick DH. Megibow AJ, Naidich DP, Hilton S, Cho KC, Balthazar EJ. Abdominal tuberculosis: CT evaluation. Radiology 1985; 157: 199-204.
  • 5. Stanley JH, Yantis PL, Marsh WH. Periportal tuberculous adenitis: a rare cause of obstructive jaundice. Gastrointest Radiol 1984; 9: 227-229.
  • 6. Mathieu D, Ladeb MF, Guigui B, Rousseau M, Vasile N. Periportal tuberculous adenitis: CT features. Radiology 1986; 161: 713-715.
  • 7. Turan M, Sen M, Koyuncu A, Aydin C, Elaldi N. Arici S. Pancreatic pseudotumor due to peripancreatic tuberculous lympadenitis. Pancreatology 2002; 2: 561-564.
  • 8. Akhan O, Pringot J. Imaging of abdominal tuberculosis. Eur Radiol 2002; 12: 312-323.
  • 9. Denton T, Hossain J. A radiological study of abdominal tuberculosis in a Saudi population, with special reference to ultrasound and computed tomography. Clin Radiol 1993; 47: 409-414.
  • 10. Ramaiya LI, Walter DF, Walter R. Sonographic features of tuberculous peritonitis. Abdom Imaging 1993, 18: 2326.
  • 11. Caroli-Bosc FX, Conio M, Maes B, Chevallier P. Hastier P, Delmont JP. Abdominal tuberculosis involving hepatic hilar lymph nodes. J Clin Gastroenterol 1997; 25:541543.
  • 12. Marshall JB, Tuberculosis of the gastrointestinal tract and peritoneum. Am J Gastroenterol 1993; 88: 989-997.
  • 13. Desai DC, Swaroop VS, Mohandas KM, Barges A, Dhir V, Nagral A, Jagannath P, Sharma OR Tuberculosis of the pancreas: reportof three cases. Am J Gastroenterol 1991; 86: 761-763.
  • 14. Chen CH. Yang CC, Yeh YH, Yang JC, Chau DA. Pancreatic tuberculosis with obstructive jaundice: a case report: Am J Gastroenterol 1999; 94: 25342536.
  • 15. Farer LS, Lowell AM, Meador MP. Extrapulmonary tuberculosis in the United States. Am J Epidemiol 1979; 109: 205-217.