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Article: Tuberculosis of pancreas and peripancreatic lymph nodes in immunocompetent patients: Experience from China

TitleTuberculosis of pancreas and peripancreatic lymph nodes in immunocompetent patients: Experience from China
Authors
Issue Date2003
PublisherBaishideng Publishing Group. The Journal's web site is located at http://www.wjgnet.com/1007-9327/index.htm
Citation
World Journal Of Gastroenterology, 2003, v. 9 n. 6, p. 1361-1364 How to Cite?
AbstractAim: To determine the clinical, radiographic and laboratory characteristics, diagnostic methods, and therapeutic variables in immunocompetent patients with tuberculosis (TB) of the pancreas and peripancreatic lymph nodes. Methods: The records of 16 patients (6 male, 10 female; mean age 37 years, range 18-56years) with tuberculosis of the pancreas and peripancreatic lymph nodes from 1983 to 2001 in the Southwest Hospital were analyzed retrospectively. In addition, 58 similar cases published in Chinese literature were reviewed and summarized. We reviewed the clinical, radiographic and laboratory findings, diagnostic methods, therapeutic approaches, and outcome in the patients. Criteria for the diagnosis of pancreatic tuberculosis were the presence of granuloma in histological sections or the presence of Mycobacterium tuberculosis DNA by polymerase chain reaction (PCR). Results: Predominant symptoms consisted of abdominal nodule and pain (75 %), anorexia/weight loss (69 %), malaise/weakness (64 %), fever and night sweats (50 %), back pain (38 %) and jaundice (31 %). Swelling of the head of the pancreas with heterogeneous attenuation echo was detected with ultrasound in 75 % (12/16). CT scan showed pancreatic mass with heterogeneous hypodensity focus in all patients, with calcification in 56 % (9/16) patients, and peripancreatic nodules in 38 % (6/16) patients. Anemia and lymphocytopenia were seen in 50 % (8/16) patients, and pancytopenia occurred in 13 % (2/ 16) patients. Hypertransaminasemia, elevated alkaline phosphatase (AP) and GGT were seen in 56 % (9/16) patients. The erythrocyte sedimentation rate (ESR) was elevated in 69 % (11/16) cases. Granulomas were found in 75 % (12/16) cases, and in 38 % (6/16) cases caseous necrosis tissue was found. Laparotomy was performed in 75 % (12/16) cases, and ultrasound-guided fine needle aspiration (FNA) was done in 63 % (10 of 16). The most commonly used combinations of medications were isoniazid/rifampin/streptomycin (63 %, n=10) and isoniazid/rifampin pyrazinamide/streptomycin or ethambutol (38 %, n=6). The duration of treatment lasted for half or one year and treatment was successful in all cases. The characteristics of 58 cases from Chinese literature were also summarized. Conclusion: Tuberculosis of the pancreas and peripancreatic lymph nodes should be considered as a diagnostic possibility in patients presenting with a pancreatic mass, and diagnosis without laparotomy is possible if only doctors are aware of its clinical features and investigate it with appropriate modalities. Pancreatic tuberculosis can be effectively cured by antituberculous drugs.
Persistent Identifierhttp://hdl.handle.net/10722/84130
ISSN
2015 Impact Factor: 2.787
2015 SCImago Journal Rankings: 1.076
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorXia, Fen_HK
dc.contributor.authorPoon, TPen_HK
dc.contributor.authorWang, SGen_HK
dc.contributor.authorBie, Pen_HK
dc.contributor.authorHuang, XQen_HK
dc.contributor.authorDong, JHen_HK
dc.date.accessioned2010-09-06T08:49:18Z-
dc.date.available2010-09-06T08:49:18Z-
dc.date.issued2003en_HK
dc.identifier.citationWorld Journal Of Gastroenterology, 2003, v. 9 n. 6, p. 1361-1364en_HK
dc.identifier.issn1007-9327en_HK
dc.identifier.urihttp://hdl.handle.net/10722/84130-
dc.description.abstractAim: To determine the clinical, radiographic and laboratory characteristics, diagnostic methods, and therapeutic variables in immunocompetent patients with tuberculosis (TB) of the pancreas and peripancreatic lymph nodes. Methods: The records of 16 patients (6 male, 10 female; mean age 37 years, range 18-56years) with tuberculosis of the pancreas and peripancreatic lymph nodes from 1983 to 2001 in the Southwest Hospital were analyzed retrospectively. In addition, 58 similar cases published in Chinese literature were reviewed and summarized. We reviewed the clinical, radiographic and laboratory findings, diagnostic methods, therapeutic approaches, and outcome in the patients. Criteria for the diagnosis of pancreatic tuberculosis were the presence of granuloma in histological sections or the presence of Mycobacterium tuberculosis DNA by polymerase chain reaction (PCR). Results: Predominant symptoms consisted of abdominal nodule and pain (75 %), anorexia/weight loss (69 %), malaise/weakness (64 %), fever and night sweats (50 %), back pain (38 %) and jaundice (31 %). Swelling of the head of the pancreas with heterogeneous attenuation echo was detected with ultrasound in 75 % (12/16). CT scan showed pancreatic mass with heterogeneous hypodensity focus in all patients, with calcification in 56 % (9/16) patients, and peripancreatic nodules in 38 % (6/16) patients. Anemia and lymphocytopenia were seen in 50 % (8/16) patients, and pancytopenia occurred in 13 % (2/ 16) patients. Hypertransaminasemia, elevated alkaline phosphatase (AP) and GGT were seen in 56 % (9/16) patients. The erythrocyte sedimentation rate (ESR) was elevated in 69 % (11/16) cases. Granulomas were found in 75 % (12/16) cases, and in 38 % (6/16) cases caseous necrosis tissue was found. Laparotomy was performed in 75 % (12/16) cases, and ultrasound-guided fine needle aspiration (FNA) was done in 63 % (10 of 16). The most commonly used combinations of medications were isoniazid/rifampin/streptomycin (63 %, n=10) and isoniazid/rifampin pyrazinamide/streptomycin or ethambutol (38 %, n=6). The duration of treatment lasted for half or one year and treatment was successful in all cases. The characteristics of 58 cases from Chinese literature were also summarized. Conclusion: Tuberculosis of the pancreas and peripancreatic lymph nodes should be considered as a diagnostic possibility in patients presenting with a pancreatic mass, and diagnosis without laparotomy is possible if only doctors are aware of its clinical features and investigate it with appropriate modalities. Pancreatic tuberculosis can be effectively cured by antituberculous drugs.en_HK
dc.languageengen_HK
dc.publisherBaishideng Publishing Group. The Journal's web site is located at http://www.wjgnet.com/1007-9327/index.htmen_HK
dc.relation.ispartofWorld Journal of Gastroenterologyen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleTuberculosis of pancreas and peripancreatic lymph nodes in immunocompetent patients: Experience from Chinaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1007-9327&volume=9&spage=1361&epage=1364&date=2003&atitle=Tuberculosis+of+pancreas+and+peripancreatic+lymph+nodes+in+immunocompetent+patients:+experience+from+Chinaen_HK
dc.identifier.emailPoon, TP: poontp@hkucc.hku.hken_HK
dc.identifier.authorityPoon, TP=rp00446en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.3748/wjg.v9.i6.1361-
dc.identifier.pmid12800257en_HK
dc.identifier.scopuseid_2-s2.0-0038727928en_HK
dc.identifier.hkuros79661en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0038727928&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume9en_HK
dc.identifier.issue6en_HK
dc.identifier.spage1361en_HK
dc.identifier.epage1364en_HK
dc.identifier.isiWOS:000183763000046-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridXia, F=15059719200en_HK
dc.identifier.scopusauthoridPoon, TP=7103097223en_HK
dc.identifier.scopusauthoridWang, SG=35410581100en_HK
dc.identifier.scopusauthoridBie, P=7006398867en_HK
dc.identifier.scopusauthoridHuang, XQ=8354378800en_HK
dc.identifier.scopusauthoridDong, JH=7403361614en_HK

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