Isolated gastric varices secondary to abdominal tuberculosis mimicking lymphoma: a case report
Abstract Background Abdominal tuberculosis (TB) rarely presents with abdominal masses and rarely causes isolated gastric varices. Case presentation We report a case of isolated gastric varices secondary to abdominal TB mimicking lymphoma. A 42-year-old woman without any history of liver disease pres...
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doaj-b04c40593b414c30990af1668c3b1bf72020-11-25T03:59:05ZengBMCBMC Gastroenterology1471-230X2019-05-011911410.1186/s12876-019-0998-9Isolated gastric varices secondary to abdominal tuberculosis mimicking lymphoma: a case reportYaoyao Gong0Shuo Li1Rong Rong2Xiaoxing Chen3Liuqin Jiang4Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Pathology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Nanjing Medical UniversityAbstract Background Abdominal tuberculosis (TB) rarely presents with abdominal masses and rarely causes isolated gastric varices. Case presentation We report a case of isolated gastric varices secondary to abdominal TB mimicking lymphoma. A 42-year-old woman without any history of liver disease presented with melena and mild abdominal pain. Upon admission to the hospital, laboratory investigations revealed a hemoglobin level of 76 g/L. Gastroduodenoscopic examination showed isolated gastric fundal varices with red color signs. Abdominal contrast-enhanced computed tomography (CECT) revealed non-enhanced masses of soft-tissue density in the lesser omental and the retropancreatic areas, multiple para-aortic lymph nodes, and multiple small hypodense splenic lesions. Positron emission tomography-CT showed hypermetabolic [F-18]2-fluoro-2-deoxyglucose activity involving multiple regional lymph nodes and the bone marrow, suggestive of lymphoma. Bone marrow biopsy revealed no abnormality. Histopathological examination of a CT-guided biopsy specimen showed granulomatous inflammation with necrosis and microorganisms that stained positive with acid-fast stains. Abdominal CECT showed a decrease in the size of the lesser omental and peripancreatic masses, as well as the para-aortic lymph nodes after 4-month anti-TB therapy. Conclusions TB should be considered among the differential diagnoses in patients with abdominal masses, isolated gastric varices, and regional lymphadenopathy. Prompt and definitive diagnosis of abdominal TB requires a coordinated approach involving laboratory tests, radiological examination, and invasive procedures for optimal decision making and management.http://link.springer.com/article/10.1186/s12876-019-0998-9Isolated gastric varicesAbdominal tuberculosisAbdominal mass |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yaoyao Gong Shuo Li Rong Rong Xiaoxing Chen Liuqin Jiang |
spellingShingle |
Yaoyao Gong Shuo Li Rong Rong Xiaoxing Chen Liuqin Jiang Isolated gastric varices secondary to abdominal tuberculosis mimicking lymphoma: a case report BMC Gastroenterology Isolated gastric varices Abdominal tuberculosis Abdominal mass |
author_facet |
Yaoyao Gong Shuo Li Rong Rong Xiaoxing Chen Liuqin Jiang |
author_sort |
Yaoyao Gong |
title |
Isolated gastric varices secondary to abdominal tuberculosis mimicking lymphoma: a case report |
title_short |
Isolated gastric varices secondary to abdominal tuberculosis mimicking lymphoma: a case report |
title_full |
Isolated gastric varices secondary to abdominal tuberculosis mimicking lymphoma: a case report |
title_fullStr |
Isolated gastric varices secondary to abdominal tuberculosis mimicking lymphoma: a case report |
title_full_unstemmed |
Isolated gastric varices secondary to abdominal tuberculosis mimicking lymphoma: a case report |
title_sort |
isolated gastric varices secondary to abdominal tuberculosis mimicking lymphoma: a case report |
publisher |
BMC |
series |
BMC Gastroenterology |
issn |
1471-230X |
publishDate |
2019-05-01 |
description |
Abstract Background Abdominal tuberculosis (TB) rarely presents with abdominal masses and rarely causes isolated gastric varices. Case presentation We report a case of isolated gastric varices secondary to abdominal TB mimicking lymphoma. A 42-year-old woman without any history of liver disease presented with melena and mild abdominal pain. Upon admission to the hospital, laboratory investigations revealed a hemoglobin level of 76 g/L. Gastroduodenoscopic examination showed isolated gastric fundal varices with red color signs. Abdominal contrast-enhanced computed tomography (CECT) revealed non-enhanced masses of soft-tissue density in the lesser omental and the retropancreatic areas, multiple para-aortic lymph nodes, and multiple small hypodense splenic lesions. Positron emission tomography-CT showed hypermetabolic [F-18]2-fluoro-2-deoxyglucose activity involving multiple regional lymph nodes and the bone marrow, suggestive of lymphoma. Bone marrow biopsy revealed no abnormality. Histopathological examination of a CT-guided biopsy specimen showed granulomatous inflammation with necrosis and microorganisms that stained positive with acid-fast stains. Abdominal CECT showed a decrease in the size of the lesser omental and peripancreatic masses, as well as the para-aortic lymph nodes after 4-month anti-TB therapy. Conclusions TB should be considered among the differential diagnoses in patients with abdominal masses, isolated gastric varices, and regional lymphadenopathy. Prompt and definitive diagnosis of abdominal TB requires a coordinated approach involving laboratory tests, radiological examination, and invasive procedures for optimal decision making and management. |
topic |
Isolated gastric varices Abdominal tuberculosis Abdominal mass |
url |
http://link.springer.com/article/10.1186/s12876-019-0998-9 |
work_keys_str_mv |
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