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Tuesday, 13 September 2016

CASE 394: COLON TUBERCULOSIS, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM


Man 43 yo with epigastric pain  crisis and  gastroendoscopy showed  gastritis.
Ultrasound  detected  one mass  like target  with  thickening of the  wall of colon (see  US 1=csoss-section  colon over  right kidney);   US  2  with linear  probe= colon wall is thickening; US 3, US 4 =  longitudinal scan).





MSCT of abdomen with CE revealed  thickening of  ascending colon wall  (CT1,  CT2).




Chest X-rays  before endoscopy  detected  infiltration of  left upper lung.





Colonoscopy reported the mass in right colon, nodular ( see foto) biopsy. 





Report of endoscopist is colon cancer.
Microscopic report  is colon tuberculosis.
Conclusion = this  case  represented colicky pain at epigastric region but  ultrasound and CT  suggested  colon cancer, same as colonoscopy, but  microscopic is tuberculosis.of colon and left lung.

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1 comment :

Hai Phuong Phan said...

This patient is lucky since it'S TB. It's hard to tell TB on Ultrasound or CT images.
Even with CXR , I would think it metastasis from colon.

I experienced few cases, patient comes up with 70-80% malignant imaging diagnosis, BEM! it's TB. And that's good cause it's curable.
I remember lession learnt from my Prof. back in Uni "always inluded TB in ddx cause it always can be TB", so true.
Goodjob, doc.