Pancreatic tuberculosis:MDCT features and differential diagnosis

Abstract

：Objective To study themulti-detector spiral CT (MDCT) features of pancreatic tuberculosis to improve theawareness and correct diagnosis. Methods Imaging features of MDCT were retrospectivelyreviewed on 9 cases with pancreatic tuberculosis that were diagnosed from 2003 to 2009,among them two patients underwent MDCT angiography, the features were compared with thoseof operative and pathological findings. Results One case of pancreatic cancer, 2 cases ofcystadenocarcinoma and 1 case of pseudocyst, 2 cases of pancreatic cancer withretroperitoneal lymph node metastasis, 2 cases of lymphoma were diagnosed by MDCT, and allthe lesions were diagnosed as pancreatic tuberculosis pathologically, and the misdiagnosisrate was 100%. Pancreatic tuberculosis often presented as pancreatic head mass, sometimespancreatic body and tail were involved. MDCT showed isopycnic or low density solid-cystmass, occasionally calcification was present, with slightly or moderate ring-likeenhancement after contrast injection. There was no enlargement of the pancreatic duct. Theretroperitoneal and adjacent lymph nodes were always enlarged with ring-like enhancement.Sometimes there was evidence of tuberculosis of other abdominal organs. ConclusionsRing-like enhanced lesions with ring-like enhanced lymph nodes without enlargement ofpancreatic duct are characteristic MDCT features of pancreatic tuberculosis.