Isolated Pancreatic Tuberculosis Mimicking Malignancy in a Dialysis Patient

Abstract

Isolated pancreatic tuberculosis is an extremely rare diagnosis and is often confused with pancreatic malignancy. A 56-yearold male dialysis patient presented with fever, loss of weight abdominal pain, and lack of appetite. The computerized tomography of pancreas demonstrated a nodular lesion, which was regularly limited, with 2.5 cm diameter on neck of pancreas. In histopathological evaluation of the biopsy sample, which was obtained from pancreatic lesion via needle biopsy under ultrasonography guidance, it was observed that granuloma formations consisted of epitheloid histiocytes and areas with caseification necrosis in centre of the some granuloma formations. Also there were the positive findings, which were consistent with the tuberculosis bacillus, in ErlichZiehl-Neelsen staining. The patient was diagnosed as pancreatic tuberculosis and started antituberculosis therapy including rifampicin, isoniaside, ethambutol, and pyrazinamide. This treatment had been continued for three months. Thereafter the treatment was continued with only rifampicin and isoniaside for six months. Signs of the disease disappeared completely.