A CASE OF COLONIC TUBERCULOSIS MISDIAGNOSED AS COLONIC CANCER

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 63; no. 10; pp. 2485 - 2488
• Main Authors: OSHIMA, Takashi, IMADA, Toshio, NAGAMINE, Kotaro, FUJII, Shoichi, NOZAWA, Akinori, IKE, Hideyuki
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 2002
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.63.2485

We report a case of primary colonic tuberculosis misdiagnosed as colonic cancer, together with some bibliographical comments. A 61-year-old man was seen at the hospital because of abdominal fullness. Barium enema study disclosed a narrowing with the shape of a hourglass in the ascending colon. This finding was different from so-called apple core, but it was misdiagnosed as colonic cancer. In addition a possibility of malignancy could not be ruled out on CT and endoscopic study and the patient was operated on. During surgery, lymph node swelling was noted, but the lesion was soft and seemed to be inflammatory disease. However, the possibility of malignancy could not also be ruled out, and a right hemicolectomy was performed. Macroscopic study of the resected material revealed annular ulcer and inflammatory polyps, and histopathologically there were multiple epithelioid nodules with giant cells in the submucosa and lymph nodes. They were negative for stain of tubercle bacillus and Ziehl-Neelsen stain, but colonic tuberculosis was definitely diagnosed based on macro- and microscopic characteristic findings. In recent years, cases of primary colonic tuberculosis account for more than 50% of all cases of colonic tuberculosis, and accordingly, the presence of primary colonic tuberculosis must be kept in mind.