Korean J Gastrointest Endosc.  2009 Dec;39(6):384-388.

A Case of Salmonella Infection in the Terminal Ileum That Was Initially Misdiagnosed as Lymphoma

Affiliations
  • 1Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea. drkimmy@yonsei.ac.kr
  • 2Department of Pathology, Yonsei University Wonju College of Medicine, Wonju, Korea.
  • 3Department of Radiology, Yonsei University Wonju College of Medicine, Wonju, Korea.

Abstract

Salmonella usually invades the Peyer's patch of the terminal ileum or ascending colon. A 55-year old female was referred to our hospital for general weakness and sustained fever. On the abdominal contrast computed tomography (CT) scan, we found symmetric circular hypertrophy of the intestinal wall and multiple hypertrophied lymph nodes in the terminal ileum. The positron emission tomography computed tomography (PET-CT) scan showed skipped areas of wall thickening and intense fluorodeoxyglucose (FDG) uptake in the terminal ileum and the ileocecal valve with adjacent lymphadenopathies. On the colonoscopy, multiple mass forming variable-sized ulcers on the terminal ileum were found, so a biopsy specimen and the colonic luminal fluid were obtained, and we made a diagnosis of lymphoma. However, the blood and colonic luminal fluid culture for Salmonella paratyphi-A was reported as positive, and therefore we corrected the diagnosis to Salmonella infection. We report here on a case of Salmonella infection in the terminal ileum, which looked like malignant lymphoma on the baseline radiologic image studies, including the CT and PET-CT.

Keyword

Salmonellosis; Lymphoma; Computed tomography; Positron emission tomography computed tomography; Colonoscopy

MeSH Terms

Biopsy
Colon
Colon, Ascending
Colonoscopy
Female
Fever
Humans
Hypertrophy
Ileocecal Valve
Ileum
Lymph Nodes
Lymphoma
Phenobarbital
Positron-Emission Tomography
Salmonella
Salmonella Infections
Ulcer
Phenobarbital
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