A Case of Behçet's Disease Mimicking Vertebral Invasion of a Mycotic Aneurysm / 대한내과학회지

Behçet's disease is a systemic vasculitis of unknown etiology characterized by recurrent oral and genital ulcers and uveitis. The vascular involvement of Behçet's disease affects arteries, veins, and blood vessels of all sizes, and it can include venous or arterial thrombosis and arterial aneurysms. There are only a few reports of an aortic aneurysm invading a vertebral body in a patient with Behçet's disease. Here, we report the case of a 45-year-old man who was initially diagnosed with vertebral invasion of a mycotic aneurysm. He underwent vascular surgery and received empirical antibiotics, but all cultures were negative. However, he had persistent, recurrent deep vein thrombosis and elevated inflammatory markers. After reviewing the pathology, a final diagnosis of Behçet's disease was made. He was successfully treated with corticosteroids. This report presents a rare case of Behçet's disease mimicking vertebral invasion of a mycotic aneurysm.

Esophago-Mediastinal Fistula Due to Tuberculous Mediastinal Lymphadenitis / 대한내과학회지

Tuberculosis rarely involves the esophagus, and most esophageal tuberculosis occurs secondary to adjacent tuberculous lymphadenitis. An esophago-mediastinal fistula is a very unusual complication of tuberculous lymphadenitis. Herein, we report a case of an esophago-mediastinal fistula due to tuberculous lymphadenitis. A 28-year-old woman who had dysphagia was assessed by chest computed tomography, endoscopy, esophagogram, and a lymph node biopsy. An esophago-mediastinal fistula was found and an antituberculous agent was considered initially. However, because of her severe dysphagia, she managed with endoscopic clipping as an alternative. However, the fistula remained on follow-up esophagography. A gastrostomy was eventually performed, and she was treated with an antituberculous agent. The fistula had closed after 4 weeks of medication. Antituberculous agents are the mainstay treatment for esophago-mediastinal fistula due to tuberculous lymphadenitis; endoscopic clipping may be a complementary treatment.

Pancreatic Lymphoma Masquerading as Autoimmune Pancreatitis / 대한췌담도학회지

Accurate diagnosis of autoimmune pancreatitis (AIP) is important to clinicians since it is difficult to differentiate AIP from pancreatic malignancies. Furthermore, unlike pancreatic malignancies, AIP has dramatic response to steroids. A 61-years-old man presented with acute pancreatitis. Imaging studies showed two separate pancreatic masses, irregular narrowing of main pancreatic duct, and a renal mass that highly suggested AIP. Endoscopic ultrasound-guided core needle biopsy of the pancreatic masses and ultrasound-guided biopsy of the renal mass revealed peripheral T-cell lymphoma. The patient is currently undergoing chemotherapy. We present a case of pancreatic lymphoma masquerading as AIP with literature review.