Tan Orkun, Luchansky Edward, Rosenman Stephen, Pua Tarah, Azodi Masoud
Department of Obstetrics and Gynecology, New York University School of Medicine, Bellevue Hospital, New York, NY 10016, USA.
Arch Gynecol Obstet. 2009 Aug;280(2):333-5. doi: 10.1007/s00404-009-0946-y. Epub 2009 Jan 31.
Tuberculosis is still a common problem in immigrant population with peritoneal tuberculosis as the most common presentation of extrapulmonary disease.
A 36-year-old woman presented with abdominal distention, night sweats and weight loss. Physical examination and radiologic studies revealed ascites, omental caking and bilateral enlarged ovaries with an elevated serum Ca-125 of 353 U/mL. Acid-fast stain and culture were negative for Mycobacterium tuberculosis. Diagnostic laparoscopy and biopsy revealed multiple granulomas with epithelioid cells and caseification necrosis confirming tuberculosis. Treatment with anti-tuberculin drugs resulted in resolution of symptoms with a reduction in Ca-125 to normal.
Laparoscopic biopsy with frozen section evaluation would spare patients with peritoneal tuberculosis from unnecessary extensive surgery. Serum Ca-125 level may be useful in monitoring treatment response.
结核病在移民人群中仍然是一个常见问题，其中腹膜结核是肺外疾病最常见的表现形式。
一名36岁女性出现腹胀、盗汗和体重减轻。体格检查和影像学研究显示有腹水、网膜饼状增厚以及双侧卵巢肿大，血清Ca-125升高至353 U/mL。结核分枝杆菌抗酸染色和培养均为阴性。诊断性腹腔镜检查及活检发现多个含有上皮样细胞和干酪样坏死的肉芽肿，确诊为结核病。抗结核药物治疗使症状缓解，Ca-125降至正常。
腹腔镜活检及冰冻切片评估可使腹膜结核患者避免不必要的广泛手术。血清Ca-125水平可能有助于监测治疗反应。
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