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Ileocaecal and transverse colonic tuberculosis mimicking colonic malignancy – A case report

INTRODUCTION: Gastrointestinal tuberculosis is common in the developing world especially in the lower socioeconomic groups. In elderly, it may mimic malignancy. CASE PRESENTATION: A 46-year-old female presented with a 6 month history of diffuse pain in abdomen with low grade fever and loss of weight...

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Autores principales: Lakhe, Prashant, Khalife, Asma, Pandya, Jayashri
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423344/
https://www.ncbi.nlm.nih.gov/pubmed/28486175
http://dx.doi.org/10.1016/j.ijscr.2017.04.016
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author Lakhe, Prashant
Khalife, Asma
Pandya, Jayashri
author_facet Lakhe, Prashant
Khalife, Asma
Pandya, Jayashri
author_sort Lakhe, Prashant
collection PubMed
description INTRODUCTION: Gastrointestinal tuberculosis is common in the developing world especially in the lower socioeconomic groups. In elderly, it may mimic malignancy. CASE PRESENTATION: A 46-year-old female presented with a 6 month history of diffuse pain in abdomen with low grade fever and loss of weight and appetite. Clinically, differential of malignancy of the large bowel was considered. The computerized tomography(CT) scan of the abdomen revealed a diffuse concentric long segmental thickening of terminal ileum, ileo ceacal junction, ascending colon and narrowing of the transverse colonic end of the splenic flexure suggesting an infective etiology. Colonoscopy showed an ulcero-nodular lesion at the splenic flexure raising the possibility of colonic cancer and thickening of ascending colon and caecum. Colonoscopic biopsy from both sites, on histopathology, showed a moderate mixed inflammation and occasional lymphoid collection and crypt abscesses in the lamina propria giving a differential of tuberculosis or Crohn‘s disease. Biopsy smear showed occasional acid fast bacilli(AFBs) and the gene Xpert detected mycobacterium tuberculosis(MTB). The patient was started on anti Koch’s therapy(AKT). DISCUSSION: In this case the differential diagnosis was malignancy of the colon, inflammatory bowel disease and tuberculosis as all these conditions may have similar clinical profile and radiological findings. Tuberculosis of bowel was considered as the most probable diagnosis due to the CT findings. But the colonoscopy suggested malignant etiology. CONCLUSION: Possibility of tuberculosis should be kept in mind while dealing with synchronous lesions in large intestine.
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spelling pubmed-54233442017-05-15 Ileocaecal and transverse colonic tuberculosis mimicking colonic malignancy – A case report Lakhe, Prashant Khalife, Asma Pandya, Jayashri Int J Surg Case Rep Case Report INTRODUCTION: Gastrointestinal tuberculosis is common in the developing world especially in the lower socioeconomic groups. In elderly, it may mimic malignancy. CASE PRESENTATION: A 46-year-old female presented with a 6 month history of diffuse pain in abdomen with low grade fever and loss of weight and appetite. Clinically, differential of malignancy of the large bowel was considered. The computerized tomography(CT) scan of the abdomen revealed a diffuse concentric long segmental thickening of terminal ileum, ileo ceacal junction, ascending colon and narrowing of the transverse colonic end of the splenic flexure suggesting an infective etiology. Colonoscopy showed an ulcero-nodular lesion at the splenic flexure raising the possibility of colonic cancer and thickening of ascending colon and caecum. Colonoscopic biopsy from both sites, on histopathology, showed a moderate mixed inflammation and occasional lymphoid collection and crypt abscesses in the lamina propria giving a differential of tuberculosis or Crohn‘s disease. Biopsy smear showed occasional acid fast bacilli(AFBs) and the gene Xpert detected mycobacterium tuberculosis(MTB). The patient was started on anti Koch’s therapy(AKT). DISCUSSION: In this case the differential diagnosis was malignancy of the colon, inflammatory bowel disease and tuberculosis as all these conditions may have similar clinical profile and radiological findings. Tuberculosis of bowel was considered as the most probable diagnosis due to the CT findings. But the colonoscopy suggested malignant etiology. CONCLUSION: Possibility of tuberculosis should be kept in mind while dealing with synchronous lesions in large intestine. Elsevier 2017-04-19 /pmc/articles/PMC5423344/ /pubmed/28486175 http://dx.doi.org/10.1016/j.ijscr.2017.04.016 Text en © 2017 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Lakhe, Prashant
Khalife, Asma
Pandya, Jayashri
Ileocaecal and transverse colonic tuberculosis mimicking colonic malignancy – A case report
title Ileocaecal and transverse colonic tuberculosis mimicking colonic malignancy – A case report
title_full Ileocaecal and transverse colonic tuberculosis mimicking colonic malignancy – A case report
title_fullStr Ileocaecal and transverse colonic tuberculosis mimicking colonic malignancy – A case report
title_full_unstemmed Ileocaecal and transverse colonic tuberculosis mimicking colonic malignancy – A case report
title_short Ileocaecal and transverse colonic tuberculosis mimicking colonic malignancy – A case report
title_sort ileocaecal and transverse colonic tuberculosis mimicking colonic malignancy – a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423344/
https://www.ncbi.nlm.nih.gov/pubmed/28486175
http://dx.doi.org/10.1016/j.ijscr.2017.04.016
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