Primary Colonic Tuberculosis, Report of a Case Masahiro Tanaka 1 , Hiroyoshi Arai 1 , Ken Kimura 1 , Ken Saito 2 1Department of Gastroenterology, Jichi Medical School 2Department of Pathology, Jichi Medical School pp.645-648
Published Date 1986/6/25
DOI https://doi.org/10.11477/mf.1403110354
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 A 34-year-old woman visited our hospital because of ileocecal pain and mass. Chest x-ray showed normal lung fields, and no infiammatory signs were found in laboratory examination. Barium enema study revealed marked deformity and narrowing limited to the ascending colon with multiple irregularly-shaped shallow ulcers. Endoscopic examination revealed circular ulcers and inflammatory polyps scattered in the ascending colon,Biopsy specimen obtained from normal appearing mucosa adjacent to the ulcers showed a tiny non-caseating epithelioid cell granuloma which closely resembles to those of Crohn's disease.

Eight weeks iater, however, tubercle bacilli were cultured and identified from the biopsy specimen taken from the ulcer bed. Antituberculosis chemotherapy was started with definitive diagnosis of colonic tuberculosis. In five weeks after the chemotherapy was instituted, remarkable improvement of the colonic lesion was confirmed by radiological and endoscopical studies.

 Generally, histological findings in biopsy specimen are not always diagnostic of intestinal tuberculosis: it is rare to find typical caseating granuloma, while it is not rare to find non-caseating granuloma in biopsy specimen. Furthermore, non-caseating granulomas are not necessarily specific to Crohn's disease. In cases of primary intestinal tuberculosis, therefore, careful radiologic and endoscopic analyses are more important in making the definitive diagnosis than histological findings.

Copyright © 1986, Igaku-Shoin Ltd. All rights reserved.


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