International Journal of Pancreatology

, Volume 29, Issue 3, pp 151–153 | Cite as

Primary tuberculosis of the pancreas mimicking a pancreatic tumor

  • Gregory KouraklisEmail author
  • Andromachi Glinavou
  • Anastasios Karayiannakis
  • Gabriel Karatzas
Case Report


Background. Diagnosis of tuberculosis of the pancreas is often missed, and may present to the clinician as a difficult diagnostic problem.

Methods. We report an extremely rare case of a 35-year-old woman who admitted for acute pain in the right upper quadrant, jaundice, fever 38°C and chills. During the last 8 mo, she developed increasing fatigue and a weight loss of approx 10 kg.

Results. Computed tomography (CT) of the abdomen showed a mass in the head of the pancreas, and upper gastrointestinal endoscopy revealed a stenosis of the second part of duodenum and a pancreatico-duodenum fistula. Frozen sections by direct trucut needle biopsy raised suspicions of a malignancy, and a Whipple procedure was performed as a radical procedure. The final histopathology revealed a chronic granulomatous lesion with caseating necrosis. Mycobacterium of tuberculosis was detected using the polymerase chain reaction-based assay.

Conclusion. This unusual case emphasizes that in suspected cases of pancreatic carcinoma with an atypical presentation, an attempt should be made to confirm the diagnosis by CT-guided needle biopsy, or by ultrasound endoscopic fine-needle aspiration.

Key Words

Tuberculosis pancreas tumor pancreatic mass 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Paraf A, Menanger C, Texier J. La tuberculose du pancreas et la tuberculose des ganglions de l’ etage superieur de l’ abdomen. Rev Med Chir Mal Foie 1966;41:101–126.PubMedGoogle Scholar
  2. 2.
    Pombo F, Soler R, Martin R. Periportal-peripancreatic tuberculous adenitis. Fortschr Rontgenstr 1990;152:142–146.CrossRefGoogle Scholar
  3. 3.
    Crowson MC, Perry M, Burden E. Tuberculosis of pancreas. A rare cause of obstructive jaundice. Br J Surg 1984;71:239.PubMedCrossRefGoogle Scholar
  4. 4.
    Gress F, Gottlieb K, Sherman S, Lehman G. Endoscopic ultrasomography-guided fine-needle aspiration biopsy of suspected pancreatic cancer. Ann Intern Med 2001;134:459–464.PubMedGoogle Scholar
  5. 5.
    Hall-Craggs MA, Lees WR. Fine needle aspiration biopsy: pancreatic and biliary tumors. AJR 1986;147:399–403.PubMedGoogle Scholar
  6. 6.
    Warshaw AL. Implications of peritoneal cytology for staging of early pancreatic cancer. Am J Surg 1991;161:26–30.PubMedCrossRefGoogle Scholar

Copyright information

© Humana Press Inc. 2002

Authors and Affiliations

  • Gregory Kouraklis
    • 1
    Email author
  • Andromachi Glinavou
    • 1
  • Anastasios Karayiannakis
    • 1
  • Gabriel Karatzas
    • 1
  1. 1.Second Department of Propedeutic SurgeryAthens University School of MedicineAthensGreece

Personalised recommendations