Calcified peripancreatic lymph nodes in pancreatic and hepatic tuberculosis mimicking pancreatic malignancy: A case report and review of literature

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ethambutol 1 infectiousdiseasesdrugs
hepatic tuberculosis 8 infectiousdiseases
isoniazid 2 infectiousdiseasesdrugs
pyrazinamide 1 infectiousdiseasesdrugs
tuberculosis 51 infectiousdiseases

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ethambutol 4647 patient was treated with antituberculous therapy for 6 months (rifampicin, isoniazid, pyrazinamide, and ethambutol for 2 months, followed by rifampicin and isoniazid for 4 months). Low back pain and abdominal pain were
isoniazid 4618 findings. Subsequently, the patient was treated with antituberculous therapy for 6 months (rifampicin, isoniazid , pyrazinamide, and ethambutol for 2 months, followed by rifampicin and isoniazid for 4 months). Low
isoniazid 4699 months (rifampicin, isoniazid, pyrazinamide, and ethambutol for 2 months, followed by rifampicin and isoniazid for 4 months). Low back pain and abdominal pain were disappeared 3 months after initial of treatment
pyrazinamide 4629 Subsequently, the patient was treated with antituberculous therapy for 6 months (rifampicin, isoniazid, pyrazinamide , and ethambutol for 2 months, followed by rifampicin and isoniazid for 4 months). Low back pain and
Select Disease Character Offset Disease Term Instance
hepatic tuberculosis 70 Title: MedicineCalcified peripancreatic lymph nodes in pancreatic and hepatic tuberculosis mimicking pancreatic malignancyA case report and review of literatureXi LiangXuequan HuangQian YangJianming
hepatic tuberculosis 751 9/2018AbstractAbstractRationale:Tuberculosis remains a serious menace to the health of people. Isolated hepatic tuberculosis is rare and pancreatic tuberculosis is extremely rare. The preoperative diagnosis of pancreatic tuberculosis
hepatic tuberculosis 1432 needle aspiration biopsy of the hepatic lesion was carried out and the cytological examination revealed hepatic tuberculosis .Interventions:The patient was treated with antituberculous therapy for 1 year.Outcomes:Low back pain
hepatic tuberculosis 2554 the head of pancreas involved both liver and pancreas.[[8],[9]] One article reported pancreatic and hepatic tuberculosis without involvement of other organs in an infant.[[10]] Here we reported a case of pancreatic and hepatic
hepatic tuberculosis 2673 tuberculosis without involvement of other organs in an infant.[[10]] Here we reported a case of pancreatic and hepatic tuberculosis without involvement of other organs in an immunocompetent person. To our knowledge, similar cases have
hepatic tuberculosis 4398 needle aspiration biopsy of the hepatic lesion was carried out and the cytological examination revealed hepatic tuberculosis (Fig. 1). The diagnosis of pancreatic and hepatic tuberculosis was confirmed based on the above findings.
hepatic tuberculosis 4461 the cytological examination revealed hepatic tuberculosis (Fig. 1). The diagnosis of pancreatic and hepatic tuberculosis was confirmed based on the above findings. Subsequently, the patient was treated with antituberculous
hepatic tuberculosis 6326 million new (incident) tuberculosis cases, highest incidence being in developing countries.[[1]] Isolated hepatic tuberculosis is rare and isolated pancreatic tuberculosis is extremely rare.[[3],[4]] Although majority of cases
tuberculosis 78 Title: MedicineCalcified peripancreatic lymph nodes in pancreatic and hepatic tuberculosis mimicking pancreatic malignancyA case report and review of literatureXi LiangXuequan HuangQian YangJianming
tuberculosis 759 9/2018AbstractAbstractRationale:Tuberculosis remains a serious menace to the health of people. Isolated hepatic tuberculosis is rare and pancreatic tuberculosis is extremely rare. The preoperative diagnosis of pancreatic tuberculosis
tuberculosis 795 remains a serious menace to the health of people. Isolated hepatic tuberculosis is rare and pancreatic tuberculosis is extremely rare. The preoperative diagnosis of pancreatic tuberculosis remains a great challenge.Patient
tuberculosis 868 tuberculosis is rare and pancreatic tuberculosis is extremely rare. The preoperative diagnosis of pancreatic tuberculosis remains a great challenge.Patient concerns:A 58-year-old Asian woman was referred to our hospital for
tuberculosis 1440 aspiration biopsy of the hepatic lesion was carried out and the cytological examination revealed hepatic tuberculosis .Interventions:The patient was treated with antituberculous therapy for 1 year.Outcomes:Low back pain
tuberculosis 1801 that calcifications in both pancreatic lesions and peripancreatic lymph nodes may suggest pancreatic tuberculosis rather than pancreatic malignancy.Introduction1Mycobacterium tuberculosis, still a serious menace to
tuberculosis 1875 nodes may suggest pancreatic tuberculosis rather than pancreatic malignancy.Introduction1Mycobacterium tuberculosis , still a serious menace to human health, can infect almost any organ in the human body.[[1],[2]] Nevertheless,
tuberculosis 2116 involvement is rare and pancreatic involvement is extremely rare.[[2]–[4]] Majority of cases of pancreatic tuberculosis occur as a part of disseminated tuberculosis, particularly in those with immunodeficiency.[[4],[5]]
tuberculosis 2161 extremely rare.[[2]–[4]] Majority of cases of pancreatic tuberculosis occur as a part of disseminated tuberculosis , particularly in those with immunodeficiency.[[4],[5]] The diagnosis of pancreatic tuberculosis can
tuberculosis 2257 disseminated tuberculosis, particularly in those with immunodeficiency.[[4],[5]] The diagnosis of pancreatic tuberculosis can easily be missed or significantly delayed because of its rarity and lack of specificity.[[2],[3],[6],[7]]
tuberculosis 2415 because of its rarity and lack of specificity.[[2],[3],[6],[7]] Two articles reported the isolated tuberculosis lesion at liver or around the head of pancreas involved both liver and pancreas.[[8],[9]] One article
tuberculosis 2562 of pancreas involved both liver and pancreas.[[8],[9]] One article reported pancreatic and hepatic tuberculosis without involvement of other organs in an infant.[[10]] Here we reported a case of pancreatic and hepatic
tuberculosis 2681 without involvement of other organs in an infant.[[10]] Here we reported a case of pancreatic and hepatic tuberculosis without involvement of other organs in an immunocompetent person. To our knowledge, similar cases have
tuberculosis 3423 patient denied fever, night sweat, weight loss, cough, vomiting, and jaundice. She denied a history of tuberculosis . Ultrasonography revealed a heteroechoic mass lesion with an unclear irregular border in the pancreatic
tuberculosis 4406 aspiration biopsy of the hepatic lesion was carried out and the cytological examination revealed hepatic tuberculosis (Fig. 1). The diagnosis of pancreatic and hepatic tuberculosis was confirmed based on the above findings.
tuberculosis 4469 cytological examination revealed hepatic tuberculosis (Fig. 1). The diagnosis of pancreatic and hepatic tuberculosis was confirmed based on the above findings. Subsequently, the patient was treated with antituberculous
tuberculosis 6243 major public health problem worldwide. In 2015, there were an estimated 10.4 million new (incident) tuberculosis cases, highest incidence being in developing countries.[[1]] Isolated hepatic tuberculosis is rare and
tuberculosis 6334 (incident) tuberculosis cases, highest incidence being in developing countries.[[1]] Isolated hepatic tuberculosis is rare and isolated pancreatic tuberculosis is extremely rare.[[3],[4]] Although majority of cases
tuberculosis 6379 incidence being in developing countries.[[1]] Isolated hepatic tuberculosis is rare and isolated pancreatic tuberculosis is extremely rare.[[3],[4]] Although majority of cases occurred as a part of disseminated tuberculosis,
tuberculosis 6482 tuberculosis is extremely rare.[[3],[4]] Although majority of cases occurred as a part of disseminated tuberculosis , about half of patients denied a previous history of tuberculosis infection and more than half showed
tuberculosis 6548 occurred as a part of disseminated tuberculosis, about half of patients denied a previous history of tuberculosis infection and more than half showed normal findings on chest radiographs.[[4],[5],[11],[12]]Several
tuberculosis 6742 radiographs.[[4],[5],[11],[12]]Several excellent articles summarized and reviewed clinical manifestations of pancreatic tuberculosis previously.[[2],[7],[12]–[15]] The clinical manifestations can be diverse and are commonly caused
tuberculosis 7110 anorexia, fever, night sweats, malaise/weakness/fatigue.[[2],[7],[12]–[15]] The diagnosis of pancreatic tuberculosis can easily be missed or significantly delayed because of its rarity and lack of specific manifestations.[[2],[7],[11]]
tuberculosis 7499 unnecessary or unproper surgery.[[15],[16]] Saluja et al[[16]] reported that even 2 of 7 pancreatic tuberculosis patients were considered for palliative chemoradiotherapy because of misdiagnosis.Accurate diagnosis
tuberculosis 7725 delays in treatment and unnecessary surgery. Imaging features are helpful for diagnosis of pancreatic tuberculosis .[[3],[6],[7],[15],[17]] Pancreatic tuberculosis may present with a wide range of imaging findings.[[3],[6],[7],[15],[17]]
tuberculosis 7773 Imaging features are helpful for diagnosis of pancreatic tuberculosis.[[3],[6],[7],[15],[17]] Pancreatic tuberculosis may present with a wide range of imaging findings.[[3],[6],[7],[15],[17]] It may present with masses
tuberculosis 8621 pancreatic duct and/or upstream biliary, lymphadenopathies surrounding the pancreas, evidence of active tuberculosis in the form of infiltrates, pleural effusion, and so on.[[3],[6],[7],[15],[17]] Vascular invasion of
tuberculosis 8815 Vascular invasion of abdominal vessels was often reported as point of distinction between pancreatic tuberculosis and malignancy.[[18]] Nevertheless, vascular involvement cannot be used as a criterion to discriminate
tuberculosis 8942 malignancy.[[18]] Nevertheless, vascular involvement cannot be used as a criterion to discriminate pancreatic tuberculosis from malignancy, as there are multiple reports of vascular invasion in pancreatic tuberculosis.[[2],[18]–[20]]
tuberculosis 9037 pancreatic tuberculosis from malignancy, as there are multiple reports of vascular invasion in pancreatic tuberculosis .[[2],[18]–[20]] Therefore, these imaging findings are nonspecific.Calcifications in pancreatic lesions
tuberculosis 9214 nonspecific.Calcifications in pancreatic lesions were reported as characteristic in diagnosis of pancreatic tuberculosis .[[3],[6],[7],[15],[17]] Although Xia et al reported that the presence of calcification in numbers as
tuberculosis 9548 al[[12]] reported that in their study, no parenchymal or ductal calcification was seen in pancreatic tuberculosis on CT scan in 32 patients. However, calcifications may be seen in pancreatic malignancies, too (Table
tuberculosis 10580 >28%.[[32],[33]] Morphological pattern of calcifications is thought as characteristic in pancreatic tuberculosis .[[3]] The morphologies are inconsistent, including irregular, striped, speckled, focal, sand-like calcifications,
tuberculosis 10982 previously,[[21],[22],[28],[30]] although there is a lack of summaries of calcifications in pancreatic tuberculosis , partly because of its rarity. Based on these reports, calcifications may be useful, but not specific
tuberculosis 11152 calcifications may be useful, but not specific imaging criteria for the differentiation of pancreatic tuberculosis from malignancy.[[3],[6],[7],[15],[17],[21],[22],[28],[30]]Table 1Ratio of calcifications in pancreatic
tuberculosis 11579 literature and no reports on diagnostic value of calcified peripancreatic lymph nodes in pancreatic tuberculosis or malignancy were found. We analyzed case reports on pancreatic tuberculosis and found that majority
tuberculosis 11657 lymph nodes in pancreatic tuberculosis or malignancy were found. We analyzed case reports on pancreatic tuberculosis and found that majority of cases of pancreatic tuberculosis with calcifications accompanied calcified
tuberculosis 11717 We analyzed case reports on pancreatic tuberculosis and found that majority of cases of pancreatic tuberculosis with calcifications accompanied calcified peripancreatic lymph nodes. From 2010, >50 cases of pancreatic
tuberculosis 11835 calcifications accompanied calcified peripancreatic lymph nodes. From 2010, >50 cases of pancreatic tuberculosis were reported.[[2],[3],[5],[7],[13],[14],[17]–[20],[34],[36]–[75]] Calcifications in pancreatic
tuberculosis 12559 lymphadenopathies with calcifications because of lack of images.[[20]] We collected all cases of pancreatic tuberculosis with calcifications as we could and collected 6 cases of pancreatic ductal adenocarcinoma with calcifications
tuberculosis 12782 as control (Table 2). Calcified peripancreatic lymph nodes accompanied calcifications in pancreatic tuberculosis in 3 of 4 patients. No calcified peripancreatic lymph nodes were observed in 6 cases of pancreatic ductal
tuberculosis 13063 that calcifications in both pancreatic lesions and peripancreatic lymph nodes may suggest pancreatic tuberculosis rather than pancreatic malignancy. Tuberculous lymphadenopathy is the most common manifestation of abdominal
tuberculosis 13185 than pancreatic malignancy. Tuberculous lymphadenopathy is the most common manifestation of abdominal tuberculosis and majority of cases of pancreatic tuberculosis occur as a part of disseminated tuberculosis.[[4],[5],[76]]
tuberculosis 13234 lymphadenopathy is the most common manifestation of abdominal tuberculosis and majority of cases of pancreatic tuberculosis occur as a part of disseminated tuberculosis.[[4],[5],[76]] It is not surprising that majority of cases
tuberculosis 13279 abdominal tuberculosis and majority of cases of pancreatic tuberculosis occur as a part of disseminated tuberculosis .[[4],[5],[76]] It is not surprising that majority of cases of pancreatic tuberculosis with calcifications
tuberculosis 13365 disseminated tuberculosis.[[4],[5],[76]] It is not surprising that majority of cases of pancreatic tuberculosis with calcifications accompanies calcified peripancreatic lymph nodes. Owing to the limited sample size,
tuberculosis 13685 peripancreatic lymph nodes accompanying pancreatic lesions with calcifications.Conclusion4Pancreatic tuberculosis is extremely rare, with a wide range of nonspecific clinical presentation and image features. The diagnosis
tuberculosis 13820 with a wide range of nonspecific clinical presentation and image features. The diagnosis of pancreatic tuberculosis can easily be missed or significantly delayed. More than half of cases of pancreatic tuberculosis were
tuberculosis 13918 pancreatic tuberculosis can easily be missed or significantly delayed. More than half of cases of pancreatic tuberculosis were initially diagnosed as pancreatic malignancy. Although the presence of calcifications should not
tuberculosis 14121 should not dissuade the doctor from raising concern for malignancy and the diagnosis of pancreatic tuberculosis should be bacteriologically or cytologically confirmed, calcifications in both pancreatic lesions and
tuberculosis 14286 confirmed, calcifications in both pancreatic lesions and peripancreatic lymph nodes may suggest pancreatic tuberculosis rather than pancreatic malignancy.Author contributionsConceptualization: Jianming He.Data curation:

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