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Japanese

Gastric Tuberculosis with Systemic Lymphadenopathy, Report of a Case Hiroki Yaita 1 , Koichi Kurahara 1 , Yumi Oshiro 2 , Naohiko Hamaguchi 3 , Toshifumi Morishita 1,4 , Shuji Kochi 1,5 , Tadahiko Fuchigami 1 1Division of Gastroenterology, Matsuyama Red Cross Hospital, Matsuyama, Japan 2Division of Pathology, Matsuyama Red Cross Hospital, Matsuyama, Japan 3Department of Respiratory Medicine, Matsuyama Red Cross Hospital, Matsuyama, Japan 4Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan 5Internal Medicine, Chihaya Hospital, Fukuoka, Japan Keyword: 胃結核 , 表面陥凹型 , 全身リンパ節腫大 , PCR法 , 抗酸菌 pp.217-224
Published Date 2017/2/25
DOI https://doi.org/10.11477/mf.1403200837
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 A 60-year-old asymptomatic man was referred to our hospital for the evaluation of a gastric lesion detected using fluorography of the stomach in a medical checkup. EGD(esophagogastroduodenoscopy)showed an irregularly shaped depressed lesion with converging folds on the posterior wall of the upper gastric corpus. Fluorine- 18-fluorodeoxyglucose positron emission tomography showed markedly increased accumulation in the lymph nodes of the mediastinum, pulmonary hilum, and upper abdomen. Chest computed tomography revealed no evidence of pulmonary tuberculosis. Biopsy of the lesion showed granulomatous inflammation with caseation necrosis and Langerhans giant cells. Acid-fast bacilli were detected using both Ziehl-Neelsen staining and mycobacterium culture. Polymerase chain reaction test for tuberculosis was also positive. Biopsy of the inguinal lymph node revealed nonspecific inflammation without any neoplastic cells or granulomas. The patient was diagnosed as having gastric tuberculosis with systemic lymphadenopathy and subsequently underwent antituberculous treatment. Six months later, the gastric lesion and lymphadenopathy were resolved.


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