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Simultaneous Carcinoma and Tuberculosis of the Colon, Report of a Case Toru Yaosaka 1 , Toshihiro Suga 1 , Yoshio Murashima 1 , Akira Maeda 3 , Toshihiro Sato 4 1Department of Gastroenterology, Sapporo Kosei Hospital 3Department of Surgery, Sapporo Kosei Hospital 4Department of Pathology, Sapporo Kosei Hospital pp.781-785
Published Date 1987/7/25
DOI https://doi.org/10.11477/mf.1403112933
  • Abstract
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 A 73 year-old woman with right para-umbilical pain was referred to our hospital for detailed examination of the colon. Neither she nor her family had any type of tuberculosis in their medical histories. Physical and laboratory examinations (Table 1) revealed no abnormalities but she had slight anemia. CEA was negative. PPD skin test was postive (20×13 mm). Acid-fast bacilli culture from her stool was negative.

 Radiological examinations (Fig. 1, 2) revealed a narrowing with some irregular niches and polypoids at the shortened cecum and ascending colon. The terminal ileum and transverse colon showed atrophic mucosal pattern with some converging folds and inflammatory polyps. These radiological findings led to the diagnosis of colonic carcinoma accompanied by intestinal tuberculosis.

 Endoscopic examinations (Fig. 3) could not prove carcinoma because of the impossibility of inserting the scope as far as the narrowed ascending colon. The transverse colon on the anal side of the carcinoma showed some converging folds and inflammatory polyps, which were diagnosed as tuberculosis.

 The surgical specimen (Fig. 4) and its histology (Fig. 6b, 7a) showed typical intestinal tuberculosis extending from the terminal ileum to the mid-transverse colon. The carcinoma was in the shortened cecum and the ascending colon (Fig. 4, 5). It was 6.5×4.0 cm in size, and invaded the serosa (si). The histological type was that of well-differentiated adenocarcinoma (Fig. 6a). There was also a dysplastic (not cancerous) part shown by histology at the anal-side margin of this carcinoma (Fig. 7b).


Copyright © 1987, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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