Primary pancreatic tuberculosis mimicking neoplasm

ABSTRACT

Tuberculosis of the pancreas is extremely rare. Diagnosis of primary tuberculosis of the pancreas is often missed, because of very low prevalence and as most of the time it mimics pancreatic tumors. We searched for the cases of tuberculous pancreatitis [TP] among all the patients who underwent exploratory laparotomy or Whipple procedure for a pancreatic mass at King Faisal Specialist Hospital, Jeddah. We review the clinical, radiological and pathological findings of those cases together with a literature review. Three cases of TP were identified; two males and one female. The age of the patients is 56, 63 and 69 years. All the patients presented with obstructive jaundice and had laparotomy for pancreatic mass. Frozen and permanent sections evaluation revealed necrotizing granulomatous inflammation that is consistent with TB that was confirmed by microbiology culture. All the patients received post operative antituberculous treatment and all are in a good condition after 1-2 years of follow-up. We conclude that although TP is very rare entity. it should be considered in the differential diagnosis in patients who present with a pancreatic mass. Frozen sections evaluation at laparotomy is usually helpful for confirmation of the diagnosis and providing material for mycobacterial culture