Multimodal Diagnosis and Management of Gastric Tuberculosis: A Case Report

Gastric tuberculosis is an exceptionally rare form of extrapulmonary tuberculosis and often presents with non-specific symptoms and endoscopic appearances, frequently mimicking submucosal tumors, peptic ulcer disease, or malignancy. These overlaps, together with the limited yield of superficial biopsies, can delay definitive diagnosis. Here, researchers report a case of gastric tuberculosis and emphasize the methodological advantage of a multimodal diagnostic strategy that integrates endoscopy, cross-sectional imaging, histopathology, and molecular testing to progressively narrow diagnostic uncertainty. Gastroscopy revealed a localized gastric lesion, while imaging provided complementary lesion characterization and suggested possible extra-gastric involvement, prompting further evaluation for granulomatous infection. Repeated endoscopic sampling did not establish a diagnosis, and laparoscopic partial gastrectomy was therefore performed to obtain adequate deep tissue for comprehensive assessment. Histopathological examination demonstrated granulomatous inflammation with caseous necrosis, and molecular testing supported infection with Mycobacterium tuberculosis complex, confirming gastric tuberculosis. The postoperative course was uneventful, and the patient subsequently received standard antituberculous therapy. Symptoms resolved, and no recurrence was observed during long-term follow-up. This case highlights practical diagnostic challenges and provides a reproducible, stepwise approach that may help clinicians suspect, differentiate, and confirm gastric tuberculosis earlier in similar presentations.