医学
内镜超声
肺结核
放射科
干酪样坏死
磁共振成像
胰腺肿瘤
胰腺肿块
背景(考古学)
胰腺癌
细针穿刺
结核分枝杆菌
活检
胰腺
病理
癌症
内科学
古生物学
生物
作者
Tomomi Miyamoto,Kazuya Tone,Shunsuke Inaki,Ryo Saito,Miku Maeda,Yuko Nagano,Taisuke Akutsu,Atsuki Furube,Mina Gochi,Kenji Motohashi,Shigeo Koido,Masamichi Takagi,Kazuyoshi Kuwano
标识
DOI:10.1016/j.clinimag.2021.09.021
摘要
Tuberculosis remains the leading cause of infectious disease related death worldwide with extrapulmonary tuberculosis being particularly difficult to diagnose. Here, we report a case of pancreatic tuberculosis (PTB) in an immunocompetent young female, which mimicked a malignant tumor diagnosed by endoscopic ultrasound-guided fine needle aspiration and biopsy (EUS-FNAB). A 19-year-old Japanese female with no prior medical history presented with abdominal epigastralgia and appetite loss lasting 2 months. A solid lobular mass was observed in the pancreatic head with enhanced abdominal computed tomography and magnetic resonance imaging suggested it was a malignant pancreatic tumor. Using EUS-FNAB, granulomas with caseous necrosis and acid-fast bacilli were observed. Polymerase chain reaction results were positive for Mycobacterium tuberculosis but negative for Mycobacterium avium complex. Therefore, the patient was diagnosed with PTB. Her symptoms and radiological findings improved with a standard antituberculosis therapy. PTB is difficult to differentiate from other pancreatic diseases with Magnetic resonance imaging (MRI) patterns of T1, T2 weighted, or diffusion-weighted image (DWI) images. To investigate novel radiological diagnostics for PTB, we focused on MRI apparent diffusion coefficient (ADC) values, which have not been investigated in this context. The present case showed 0.52 × 10-3 mm2/s; additionally, the mean value of other mass-forming pancreatic diseases, such as pancreatic cancer was 1.592 × 10-3 mm2/s (the range: 1.015-3.025 × 10-3 mm2/s). The range does not overlap with the present PTB case or other pancreatic diseases. Therefore, ADC values may be useful as a noninvasive radiological diagnostic method for PTB.
科研通智能强力驱动
Strongly Powered by AbleSci AI