Date Published: January 02, 2020
Publisher: Wolters Kluwer
Author(s): Hasan Maulahela, Ahmad Fauzi, Nur Rahadiani.
A 28-year-old woman suffered from abdominal pain for 3 weeks before admission. The patient also had weight loss and a decrease in appetite. From the physical examination, we found abdominal tenderness in the right upper quadrant. The result of magnetic resonance imaging was a suspected pancreatic cyst. Endoscopic ultrasound (EUS) showed a hypoechoic lesion with a definite border in the head of the pancreas with lymph node enlargement (Figure 1). We performed fine-needle aspiration of the lesion which oozed pus (Figure 2). The fluid was sent for cytology examination and tuberculosis polymerase chain reaction (PCR). The cytology result showed giant cell granuloma, and the tuberculosis PCR was positive (Figure 3). We performed aspiration of the abscess 3 times every 2 months until there was no pus aspirated and started administration of antituberculosis drugs for 9 months. EUS evaluation was performed every 2 months. After treatment with antituberculosis medication, the patient’s abdominal pain was reduced, and she gained weight. EUS showed a decrease in size of the abscess and lymph nodes. The abscess resolved after 9 months (Figure 4).
Author contributions: H. Maulahela, A. Fauzi, and N. Rahadiani wrote the manuscript. H. Maulahela is the article guarantor.