A Case of Biliary Tract Tuberculosis Indistinguishable from Solid and Cystic Tumor of the Pancreas

Takafumi Sekka, Go Wakabayashi, Masahiko Jinzaki*, Kunio Ido*, Seiichiro Ishii, Hiroaki Kitagawa, Yuko Kitagawa, Kenji Matsumoto, Isao Yokoyama, Katsuhiko Nohga

Department of Surgery, Kawasaki Municipal Hospital
*Department of Radiology, Nihonkohkan Hospital

A case of biliary tract tuberculosis that was difficult to differentiate from solid and cystic tumor (SCT) of the pancreas was treated. The patient was a 25-year-old woman from Philippines. She was admitted to our hospital with complaints of dull continuous upper right quadrant pain. Laboratory findings showed no abnormality. Abdominal ultrasonography and computed tomography revealed a multi-lobular cystic mass with solid components. Celiac angiography showed dilation and displacement of the epitholedochal plexus. Portography showed stenosis and displacement of the main trunk of the portal vein. No significant findings of tumor stains or encasements were found. A solid and cystic tumor of the pancreas was our preoperative diagnosis. Laparotomy was performed and frozen pathological examination revealed no malignant cells, but Langhans'giant cells were found. The tumor was resected. The postoperative pathological diagnosis was tuberculous adenitis. The morphological features of tuberculous adenitis of the biriary tract are similar to SCT of the pancreas. Therefore, a means of differential diagnosis has to emerge.

Key words
intraabdominal tuberculous adenitis, biliary tract tuberculosis, solid and cystic tumor of the pancreas

Reprint requests
Katsuhiko Nohba Department of Surgery, Kawasaki Municipal Hospital
12-1 Shinkawa-dori. Kawasaki-ku, Kawasaki, 210 JAPAN

Accepted
June 14, 1993

To read the PDF file you will need Abobe Reader installed on your computer.