Context Isolated tuberculosis of the ampulla of Vater has not yet been reported. The clinical features of isolated periampullary tuberculosis are at times similar to those seen in patients with periampullary carcinoma. Diagnosis is difficult, and biopsy and culture of the suspected lesion are often negative for Mycobacterium tuberculosis. Case report We herein describe one such case masquerading as periampullary carcinoma in a 70-year-old woman. Due to comorbid conditions only a local excision of the ampulla was carried out. Histopathology revealed giant cells in the absence of caseation necrosis and the presence of Mycobacterium tuberculosis was proven using the polymerase chain reaction. Conclusion Isolated tuberculosis of ampulla of Vater is extremely rare but must be kept in mind when making the differential diagnosis of isolated ampullary lesion.
Mallika Tewari, Raghvendra Raman Mishra, Vinay Kumar, Amrita Ghosh Kar, Hari S Shukla