LAUSR

espanolLa tuberculosis ganglionar peripancreatica primaria es una entidad excepcional especialmente en pacientes inmunocompetentes, pero su incidencia esta incrementandose en nuestro medio durante los ultimos anos debido a la creciente inmigracion. Suele presentarse como una masa pancreatica y se diagnostica erroneamente como neoplasia de pancreas en la mayoria de los casos, realizandose el diagnostico de tuberculosis tras la cirugia. Presentamos el caso de un varon de 38 anos pakistani con un cuadro de dolor abdominal de varios meses de evolucion que inicialmente se diagnostico de neoplasia pancreatica tras detectar mediante tomografia computarizada (TC) y resonancia magnetica nuclear (RMN) abdominal una masa en el istmo pancreatico. No obstante, tras realizar una ecoendoscopia con toma de biopsias mediante puncion-aspiracion con aguja fina (PAAF) se diagnostico de tuberculosis ganglionar peripancreatica. Tras recibir tratamiento antituberculoso el paciente presento mejoria clinica, a pesar de una escasa reduccion del tamano de la lesion. En conclusion, la tuberculosis ganglionar peripancreatica forma parte del diagnostico diferencial de la neoplasia de pancreas. La toma de biopsias guiada por ecoendoscopia representa una herramienta diagnostica de gran valor y utilidad en la deteccion de dicha patologia, evitando realizar cirugias con elevada morbimortalidad. EnglishPrimary peripancreatic lymph node tuberculosis is an exceptional entity in immunocompetent patients, but its incidence is increasing in developed countries in recent years due to increasing immigration. It usually presents as a pancreatic mass and is misdiagnosed as pancreatic neoplasia in most cases, with the diagnosis of tuberculosis occurring after surgery. We report the case of a 38 year old Pakistani man with abdominal pain of several months duration, who was initially diagnosed with a pancreatic neoplasm after detecting a mass in the pancreatic isthmus by computed tomography (CT) and abdominal magnetic resonance imaging (MRI). However, after performing an endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB), the patient was diagnosed with peripancreatic lymph node tuberculosis. After receiving anti-tuberculous treatment, the patient presented clinical improvement, despite a small reduction in the lesion size. In conclusion, peripancreatic lymph node tuberculosis is part of the differential diagnosis of pancreatic neoplasia. Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) represents a valuable and useful diagnostic tool for detecting this pathology, avoiding surgeries with a high morbidity and mortality.