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Isolated gastric varices secondary to abdominal tuberculosis mimicking lymphoma: a case report

BACKGROUND: Abdominal tuberculosis (TB) rarely presents with abdominal masses and rarely causes isolated gastric varices. CASE PRESENTATION: We report a case of isolated gastric varices secondary to abdominal TB mimicking lymphoma. A 42-year-old woman without any history of liver disease presented w...

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Autores principales: Gong, Yaoyao, Li, Shuo, Rong, Rong, Chen, Xiaoxing, Jiang, Liuqin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6540571/
https://www.ncbi.nlm.nih.gov/pubmed/31138138
http://dx.doi.org/10.1186/s12876-019-0998-9
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author Gong, Yaoyao
Li, Shuo
Rong, Rong
Chen, Xiaoxing
Jiang, Liuqin
author_facet Gong, Yaoyao
Li, Shuo
Rong, Rong
Chen, Xiaoxing
Jiang, Liuqin
author_sort Gong, Yaoyao
collection PubMed
description BACKGROUND: Abdominal tuberculosis (TB) rarely presents with abdominal masses and rarely causes isolated gastric varices. CASE PRESENTATION: We report a case of isolated gastric varices secondary to abdominal TB mimicking lymphoma. A 42-year-old woman without any history of liver disease presented with melena and mild abdominal pain. Upon admission to the hospital, laboratory investigations revealed a hemoglobin level of 76 g/L. Gastroduodenoscopic examination showed isolated gastric fundal varices with red color signs. Abdominal contrast-enhanced computed tomography (CECT) revealed non-enhanced masses of soft-tissue density in the lesser omental and the retropancreatic areas, multiple para-aortic lymph nodes, and multiple small hypodense splenic lesions. Positron emission tomography-CT showed hypermetabolic [F-18]2-fluoro-2-deoxyglucose activity involving multiple regional lymph nodes and the bone marrow, suggestive of lymphoma. Bone marrow biopsy revealed no abnormality. Histopathological examination of a CT-guided biopsy specimen showed granulomatous inflammation with necrosis and microorganisms that stained positive with acid-fast stains. Abdominal CECT showed a decrease in the size of the lesser omental and peripancreatic masses, as well as the para-aortic lymph nodes after 4-month anti-TB therapy. CONCLUSIONS: TB should be considered among the differential diagnoses in patients with abdominal masses, isolated gastric varices, and regional lymphadenopathy. Prompt and definitive diagnosis of abdominal TB requires a coordinated approach involving laboratory tests, radiological examination, and invasive procedures for optimal decision making and management.
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spelling pubmed-65405712019-06-03 Isolated gastric varices secondary to abdominal tuberculosis mimicking lymphoma: a case report Gong, Yaoyao Li, Shuo Rong, Rong Chen, Xiaoxing Jiang, Liuqin BMC Gastroenterol Case Report BACKGROUND: Abdominal tuberculosis (TB) rarely presents with abdominal masses and rarely causes isolated gastric varices. CASE PRESENTATION: We report a case of isolated gastric varices secondary to abdominal TB mimicking lymphoma. A 42-year-old woman without any history of liver disease presented with melena and mild abdominal pain. Upon admission to the hospital, laboratory investigations revealed a hemoglobin level of 76 g/L. Gastroduodenoscopic examination showed isolated gastric fundal varices with red color signs. Abdominal contrast-enhanced computed tomography (CECT) revealed non-enhanced masses of soft-tissue density in the lesser omental and the retropancreatic areas, multiple para-aortic lymph nodes, and multiple small hypodense splenic lesions. Positron emission tomography-CT showed hypermetabolic [F-18]2-fluoro-2-deoxyglucose activity involving multiple regional lymph nodes and the bone marrow, suggestive of lymphoma. Bone marrow biopsy revealed no abnormality. Histopathological examination of a CT-guided biopsy specimen showed granulomatous inflammation with necrosis and microorganisms that stained positive with acid-fast stains. Abdominal CECT showed a decrease in the size of the lesser omental and peripancreatic masses, as well as the para-aortic lymph nodes after 4-month anti-TB therapy. CONCLUSIONS: TB should be considered among the differential diagnoses in patients with abdominal masses, isolated gastric varices, and regional lymphadenopathy. Prompt and definitive diagnosis of abdominal TB requires a coordinated approach involving laboratory tests, radiological examination, and invasive procedures for optimal decision making and management. BioMed Central 2019-05-28 /pmc/articles/PMC6540571/ /pubmed/31138138 http://dx.doi.org/10.1186/s12876-019-0998-9 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Gong, Yaoyao
Li, Shuo
Rong, Rong
Chen, Xiaoxing
Jiang, Liuqin
Isolated gastric varices secondary to abdominal tuberculosis mimicking lymphoma: a case report
title Isolated gastric varices secondary to abdominal tuberculosis mimicking lymphoma: a case report
title_full Isolated gastric varices secondary to abdominal tuberculosis mimicking lymphoma: a case report
title_fullStr Isolated gastric varices secondary to abdominal tuberculosis mimicking lymphoma: a case report
title_full_unstemmed Isolated gastric varices secondary to abdominal tuberculosis mimicking lymphoma: a case report
title_short Isolated gastric varices secondary to abdominal tuberculosis mimicking lymphoma: a case report
title_sort isolated gastric varices secondary to abdominal tuberculosis mimicking lymphoma: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6540571/
https://www.ncbi.nlm.nih.gov/pubmed/31138138
http://dx.doi.org/10.1186/s12876-019-0998-9
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