Pancreatic Tuberculosis: Role of Multidetector Computed Tomography

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Pancreatic Tuberculosis: Role of Multidetector Computed Tomography Gehan Fawzy Ibrahim, MD, Nizar A. Al-Nakshabandi, MD, FRCPC Canadian Association of Radiologists Journal Volume 62, Issue 4, Pages 260-264 (November 2011) DOI: 10.1016/j.carj.2010.05.001 Copyright © 2011 Canadian Association of Radiologists Terms and Conditions

Figure 1 A 48-year-old man presented with right upper quadrant pain. Arterial phase axial computed tomography, showing an ill-defined hypodense mass lesion at the body of the pancreas (red arrow); adjacent hypodense lymph nodes, with peripheral rim of enhancement; 1 node is seen compressing the gastric lesser curvature (green arrows). This figure is available in colour online at http://www.carjonline.org/. Canadian Association of Radiologists Journal 2011 62, 260-264DOI: (10.1016/j.carj.2010.05.001) Copyright © 2011 Canadian Association of Radiologists Terms and Conditions

Figure 2 A 60-year-old man with known chronic granulomatous pancreatitis. Arterial phase axial computed tomography, showing diffuse coarse calcifications of the pancreas (arrow), along with a heterogeneous soft-tissue mass located at the head and uncinate process. (A) A trace amount of peripancreatic fluid is also noted. (B) Distal pancreatic atrophy and dilated pancreatic duct (arrow) mimic pancreatic head neoplasm. Canadian Association of Radiologists Journal 2011 62, 260-264DOI: (10.1016/j.carj.2010.05.001) Copyright © 2011 Canadian Association of Radiologists Terms and Conditions

Figure 3 (A) A 42-year-old man presented with back and abdominal pain. Arterial phase axial computed tomography (CT), showing a multiloculated cystic lesion related to the pancreatic tail, with pressure effect upon the gastric greater curvature that mimics cystic neoplasm, proved by fine needle aspiration to be peripancreatic necrotic tuberculosis (TB) lymph nodes. (B) Arterial phase axial CT of the chest of the same patient, revealing right loculated pleural effusion and multiple chest wall cystic lesions encroaching upon the right sixth dorsal nerve root and the thecal sac, with right sixth rib destruction; proved to be TB abscesses and effusions. Canadian Association of Radiologists Journal 2011 62, 260-264DOI: (10.1016/j.carj.2010.05.001) Copyright © 2011 Canadian Association of Radiologists Terms and Conditions

Figure 4 (A) A 55-year-old woman admitted with right hypochondrial pain. Arterial phase axial computed tomography (CT), showing multiple, large, well-defined multiloculated cystic masses with rim enhancement related to the head and neck of the pancreas, with remarkable mass effect on the inferior vena cava, mimicking cystic pancreatic neoplasm. (B) Follow-up CT of the same patient after 9 months of anti-TB treatment, revealing significant interval resolution of previously noted peripancreatic necrotic lymph nodes. Canadian Association of Radiologists Journal 2011 62, 260-264DOI: (10.1016/j.carj.2010.05.001) Copyright © 2011 Canadian Association of Radiologists Terms and Conditions