Abstract
A 57-year-old woman complaining of epigastric pain and weight loss was diagnosed as having an about 6-cm sized pancreatic tumor by abdominal US at other clinic and was referred to our hospital for surgery. General condition was good. No jaundice and hepatic dysfunction were noted. The abdomen was flat and soft and no abdominal tumor was palpable. Abdominal CT and MRI revealed an about 6-cm sized multi-lobular cystic mass with solid components at the pancreas head. Tumor markers were in normal ranges. Therefore, we diagnosed the case as malignant transformation of intraductal papillary mucinous neoplasm (IPMN) and performed pancreatoduodenectomy (PD). On postoperative pathology, the pancreas was found to be normal and there was lymphadenopathy around the pancreas. Moreover, we found Langhans giant cells and a granuloma consisting of epithelioid cells with caseation necrosis in the lymphadenopathy. Finally tuberculous lymphadenitis was diagnosed. Tuberculous lymphadenitis of abdominal lymph node is rare in Japan. It has been reported that the disease commonly affects patients with immunodeficiency, but she had been well without history of tuberculosis. We report this rare case of tuberculous lymphadenitis around the pancreas mimicking IPMN of the pancreas.
