TUBERCULOUS MESENTERIC LYMPHADENITIS MIMICKING PANCREATIC-CARCINOMA

Tuberculous mesenteric lymphadenitis is a rare clinical entity and non -surgical diagnosis of this condition remains a challenge. A 38-year-o ld Indian woman presented with a six-week history of epigastric pain, low-grade fever and anorexia. Upper endoscopy showed a gastric ulcer o f the posterior wall of the stomach. On CT scan there was a 8 cm abdom inal mass involving the pancreatic body and tail and the endoscopic ul trasonography was also compatible with a cystic pancreatic tumor which had eroded into the stomach. An exploratory laparotomy was performed and the diagnosis of tuberculous mesenteric lymphadenitis was confirme d by bacteriological and histological examinations. Medical therapy wa s started after surgery. At 18 months she is asymptomatic and abdomina l CT scan is normal. Tuberculosis of mesenteric lymph nodes usually ra ises serious diagnostic problems. A high grade of suspicion is necessa ry in order to perform a pre-operative diagnosis.