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Rectal submucosal tumor-like lesion originating from intestinal tuberculosis
1Department of Surgery, Koshigaya Hospital, Dokkyo University School of Medicine, Saitama, Japan.
Journal of Gastroenterology
|January 16, 1998
Summary
A rectal submucosal lesion, initially suspected to be tuberculosis, was successfully treated with transsacral local excision. Histological examination confirmed tuberculosis, revealing granulomas and giant cells.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Surgical Pathology
Background:
- Tuberculosis (TB) can present with unusual manifestations, including gastrointestinal involvement.
- Rectal submucosal lesions require accurate diagnosis for appropriate management.
Observation:
- A 55-year-old man incidentally found to have a 2 cm rectal submucosal lesion during anal fistulectomy.
- Imaging studies (barium enema, colonoscopy, CT, MRI) suggested a submucosal mass, but biopsies were inconclusive.
- Digital rectal examination suggested an extramural origin for the lesion.
Findings:
- Transsacral local excision was performed for diagnosis and treatment.
- Histopathology revealed a foreign-body granuloma with acute inflammation.
- Caseating granulomas and Langhans' giant cells confirmed tuberculosis as the etiology.
Implications:
- The transsacral approach is a viable option for diagnosing and treating rectal submucosal lesions when endoscopic biopsies are non-diagnostic.
- This case highlights the importance of considering tuberculosis in the differential diagnosis of rectal submucosal lesions, even with atypical presentations.
- Early and accurate diagnosis of rectal tuberculosis is crucial for effective treatment and preventing complications.