Pancreatic tuberculosis in a human immunodeficiency virus positive patient: A case report

Jianfeng Cheng, Kiranmayi Tadi, Michelle Halpern, Mirela Feurdean, Joseph McNelis, Jeffrey Brensilver

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Despite the increased incidence of tuberculosis related to human immunodeficiency virus (HIV) in recent decades, pancreatic tuberculosis has rarely been described. We report a case of pancreatic tuberculosis in a 39-year-old African man who presented with progressive dysphagia, vomiting, weight loss and productive cough, accompanied by localized epigastric pain and one episode of melena. HIV-1 testing was positive and lymphocyte subset profile showed CD4 count of 9/mm3. Abdominal computed tomography (CT) scan with contrast revealed a cystic mass in the body of the pancreas, significant portal and retroperitoneal cystic adenopathy, and multiple cystic lesions in the spleen and liver. CT guided cyst aspiration and node biopsy detected Mycobacterium tuberculosis. The patient responded well on antituberculosis and antiretroviral therapy. Tuberculosis rarely involves the pancreas, probably due to the presence of pancreatic enzymes which interfere with the seeding of Mycobacterium tuberculosis. Pancreatic tuberculosis is considered to be the result of dissemination of the infection from nearby lymphatic nodes. Endoscopic ultrasound or CT guided fine needle aspiration for cytology is the recommended diagnostic technique. Although the prognosis is good with antituberculosis treatment, it could be fatal without correct diagnosis and treatment. The clinician's high index of suspicion of pancreatic tuberculosis and application of FNAB to obtain pathological evidence are extremely important to a correct diagnosis, especially in young HIV positive patients.

Original languageEnglish (US)
Pages (from-to)939-940
Number of pages2
JournalWorld Journal of Gastroenterology
Volume14
Issue number6
DOIs
StatePublished - Feb 14 2008

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Keywords

  • CT-guided fine needle biopsy
  • Human immunodeficiency virus infection
  • Pancreatic tuberculosis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Cheng, J., Tadi, K., Halpern, M., Feurdean, M., McNelis, J., & Brensilver, J. (2008). Pancreatic tuberculosis in a human immunodeficiency virus positive patient: A case report. World Journal of Gastroenterology, 14(6), 939-940. https://doi.org/10.3748/wjg.14.939