Tumor-like tuberculosis

Kim, S Y

Abstract

It was known that some of the abdominal tuberculosis can produce tumor-like appearance clinically andradiologically. But these were mainly masses formed in mesenteric and retroperitoneal lymph nodes. The author hasexperienced the gastrointestinal tuberculosis resembling to a neoplastic process. In the gastric tuberculosis,irreqular narrowing and filling defect with mucosal distortion and occasional shoulder effect could be seen inpyloric antrum. Deformity of proximal portion of duodenum was noted in most cases. Difficulty in differentialdiagnosis from the gastric cancer might be encountered, if duodenum was not involved. No definite sign of muxosaldestruction in involved are and associated deformity of duodenum was suggsestive of an inflammatory lesional. Ifthere is any tuberculous changes in small bowel, then gastric tuberculosis is more likely. There was thetuberculosis of descending duodenum or pancreaticoduodenal group of lymph nodes revealed cancer-like appearance.Long irregular narrowing with nodular filling defect and mucosal distortion or inverted 3 sign was evident.Differential diagnosis from cancer in duodenum or pancrease could not be made radiographically. Short annularstenosis and nodular filling defect with shoulder effect in both ends of stenosis was noted in some of the smallbowel tuberculosis. the findings were very resemble to malignancy. There was a case of huge hepatoma-liketuberculosis formed a large irregular mass by lymph nodes and adjacent organs. Chest film was not much help in thedifferential diagnosis. In many cases of the gastrointestinal tuberculosis, radiological findings were resembledto a neoplastic process. Since none of radiologic findings are specific enough to allow one to make a definitivediagnosis of the gastrointestinal tuberculosis and since sever type of the gastrointestinal tuberculosis could becured by chemotherapy, careful analyzation of clinical features is emphasized before surgery.