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Gastric tuberculosis presenting with a huge abdominal mass
Jun Uk Lim1, Yee Hyung Kim1, Cheon Woong Choi1
1Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, 149 Sangil-dong, Gangdong-gu, Seoul 134-727, Republic of Korea. kumc92@naver.com.
Singapore Medical Journal
|December 21, 2013
Summary
Gastric tuberculosis, a rare condition, was diagnosed in a woman presenting with epigastric mass. Diagnostic imaging and biopsy confirmed Mycobacterium tuberculosis, leading to successful treatment and lesion resolution.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Radiology
Background:
- Tuberculosis (TB) typically affects the lungs, with gastric TB being exceptionally rare.
- Early diagnosis of gastric TB is challenging due to non-specific symptoms and rarity.
Observation:
- A 38-year-old woman presented with persistent epigastric discomfort and a palpable mass.
- Imaging revealed a large, irregularly contoured low-attenuation mass in the stomach.
- Endoscopic examination showed a protruding ulcerative mass with a subepithelial lesion, initially misdiagnosed as a gastrointestinal stromal tumor.
Findings:
- Acid-fast bacillus staining and polymerase chain reaction (PCR) on endoscopic biopsy confirmed Mycobacterium tuberculosis.
- Abdominal computed tomography (CT) and endoscopy demonstrated near-complete resolution of the gastric lesion after three months of treatment.
Implications:
- This case highlights the importance of considering gastric tuberculosis in the differential diagnosis of gastric masses, especially in endemic areas.
- Accurate diagnosis through microbiological confirmation is crucial for appropriate treatment and management of this rare condition.
- Prompt diagnosis and treatment led to successful clinical and radiological resolution, underscoring the efficacy of anti-TB therapy.
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