Pancreatic Mass: Include Tuberculosis in the Differential Diagnosis

Abstract

Although abdominal tuberculosis (TB) is quite prevalent in endemic regions, involvement of the pancreas is considerably rare. We describe a case of pancreatic TB presenting as a pancreatic mass in a patient with abdominal pain and jaundice. Due to the similar presentation, it can easily be misinterpreted as a pancreatic neoplasm. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) can help confirm the diagnosis in such cases by providing histopathological evidence of Mycobacterium tuberculosis infection. The patient made a remarkable recovery post anti-tuberculous therapy (ATT) initiation. This exceptional response of pancreatic TB to conservative management makes it imperative that the condition be diagnosed promptly to avoid any futile surgical interventions and associated complications. This can only be achieved if clinicians are aware of the diagnostic possibility of pancreatic TB presenting as a mass in the pancreas.