ABSTRACT
According to the global cancer observatory (GLOBOCAN), there were 16,485 new cases of pancreatic cancer in Southeast Asia in 2020, with men (9458 cases) having the highest incidence compare to woman (8320 cases). The death rate from 16,485 cases was 16,167cases (98%). A person's chance of developing pancreatic cancer in addition to other cancers is between 1% to 20%. In this study, we reported a case of pancreatic tumor with lung tumor. A 68 years old woman presented with right quadrant abdominal pain since 1 month ago. The pain occurs randomly, but mostly occur during night. The pain didn’t occur after eat fatty food and during exercise. The pain didn’t relieve by rest. The patient also experienced nausea and vomit. The vomit consist of food and blood. Shecomplains black colored stools and dark yellow urine. She also lost weight from 62 kg to 47 kg. There was history of gastric bleeding in 4 month ago. She was passive smoker. We then did several tests such as complete blood count, blood chemistry, serology, chest x-ray and abdominal CT-scan. The test showed pancreatic tumor with suggestive primary lung tumor. Patient with multiple primary tumor are an extremely rare type of cancer, which need comprehensive approach to both diagnosis and treatment of these numerous primary tumors.
ABSTRACT
Tuberculosis (TB) is one of the top 10 infectious diseases causing mortality worldwide. In 2019, approximately 10 million people were diagnosed with TB, with 5.6 million men, 3.2 million women, and 1.2 million children. One of the hallmarks of the course of TBis tuberculous granuloma. In this study, we reported a case of TB granuloma and further workup to exclude other etiologies. A 52-year-old man presented with a complaint of a lump on his left neck. There was a history of prolonged productive cough, weight loss, and shortness of breath. Chest radiograph and FNAB of the lump suggested pulmonary TB while the rapid molecular test was negative. The patient was also suspected of malignancy; but the trans-thoracal biopsy did not reveal any malignant cells. The patient was eventually diagnosed with granuloma due to primary TBwith cervical lymphadenopathy.Tuberculous granuloma is one of the most common pulmonary granulomasand a hallmark of the course of TB. It is characterized by the immune system forming an environment to control the spread of the infection. In cases of tuberculous granuloma with negative rapid molecular test, further investigations should be conducted to find evidence of TB infection. Activated TB granuloma can spread to the surrounding tissues or organs.A negative rapid molecular test result does not necessarily exclude TB in endemic regions; thus, further investigations such as CT scans or histopathological examination are required to find features of TB infection.