Immunocompetent individuals presenting pancreatic ailments resembling pancreatic cancer: Case study and diagnostic methods
A 32-year-old woman from India and Pakistan presented with atypical epigastric pain that had persisted for two months. The patient, who had undergone cholecystectomy for cholelithiasis several years prior, had no history of jaundice, fever, or unexplained weight loss.
Upon examination, routine laboratory tests revealed no significant abnormalities. However, the QuantiFERON test, a test used to detect latent tuberculosis infection, returned positive, raising the suspicion of tuberculosis.
A CT scan revealed a 50 mm mass located in the head of the pancreas, with invasion into the portal trunk, celiac trunk, and common hepatic artery. The mass exhibited a heterogeneous appearance, with both solid and necrotic components. Coeliac lymphadenopathy was also observed.
Despite the challenging nature of diagnosing pancreatic tuberculosis due to its low incidence and nonspecific symptoms, further investigation led to a confirmatory diagnosis. Pancreatic tuberculosis is a rare condition, accounting for less than 4.7% of cases in some studies.
The patient received anti-tuberculosis therapy, leading to favorable outcomes, including pain resolution and normalization of follow-up imaging. No signs of distant metastasis, ascites, or peripancreatic fluid collection were observed.
It is important to note that pancreatic tuberculosis can present with atypical symptoms, making it crucial for healthcare providers to consider this rare but possible diagnosis in patients with unexplained abdominal pain.
White blood cell count was 10,600/mm, and CRP level was 19 mg/l (elevated). Lipasemia was slightly elevated at 39 UI/L. The patient's sex was female.
This case serves as a reminder of the importance of considering rare but possible diagnoses, especially in patients with atypical symptoms and a history of residence in areas with high tuberculosis prevalence.
