Shibagaki Keiichi, Miyaike Jirou, Onji Morikazu, Tange Kazuhiro, Bandou Kenji, Takeji Satoru, Murakami Takatoshi, Ogawa Taiji, Yamaguchi Tomotaka, Uehara Takahide, Hasebe Aki, Kawasaki Keitarou, Oomoto Masaki
Department of Internal Medicine and Gastroenterology, Saiseikai Imabari Hospital, Ehime, Japan,
Clin J Gastroenterol. 2015 Aug;8(4):207-11. doi: 10.1007/s12328-015-0582-y. Epub 2015 Jul 12.
A 76-year-old male had a solitary submucosal tumor-like lesion in the sigmoid colon originating from tuberculosis. The lesion, up to 1 cm in diameter, was found incidentally during a routine colonoscopy, which revealed a protuberant submucosal growth with a shallow depression of the overlying mucosa in the center of the tumor. Histologically, the endoscopic biopsy revealed caseating granulomas and infiltration of Langhans giant cells and epithelioid cells, consistent with tuberculosis, were also observed. Five reports of similar lesions from colon tuberculosis were found in a literature review, including the present case. In all cases, the submucosal tumor-like lesions which originated from tuberculosis were small and in an active stage of tuberculosis. Five cases of submucosal tumor-like lesions from gastric tuberculosis were also reported, with characteristics very similar to those of the lesions from colon tuberculosis. Therefore, we propose that lesions originating from tuberculosis should be included in the differential diagnosis of submucosal tumor-like lesions in the colon and stomach.
一名76岁男性在乙状结肠有一个源于结核的孤立性黏膜下肿瘤样病变。该病变直径达1厘米，在常规结肠镜检查时偶然发现，结肠镜检查显示为突出的黏膜下肿物，肿瘤中心覆盖黏膜有浅凹陷。组织学上，内镜活检显示干酪样肉芽肿，还观察到朗汉斯巨细胞和上皮样细胞浸润，符合结核表现。文献复习发现包括本病例在内的5篇关于结肠结核类似病变的报道。所有病例中，源于结核的黏膜下肿瘤样病变均较小且处于结核活动期。另外还报道了5例源于胃结核的黏膜下肿瘤样病变，其特征与结肠结核病变非常相似。因此，我们建议将源于结核的病变纳入结肠和胃黏膜下肿瘤样病变的鉴别诊断。
