Ryu Sunjin, Kang Bo-Kyeong, Kim Mimi, Lee Chul-Min
J Korean Soc Radiol. 2024 May;85(3):637-642. doi: 10.3348/jksr.2023.0080. Epub 2024 Mar 5.
Rectal syphilis is a rare form of syphilis presentation and its symptoms, endoscopic and radiologic findings are nonspecific. Rectal syphilis typically presents with features such as concentric rectal wall thickening, mucosal hyperemia, perirectal fat stranding, and lymphadenopathy. Rectal cancer exhibits asymmetric wall thickening and lymph node necrosis, aiding in the differentiation between these two diseases. However, due to the considerable overlap in their respective manifestations, distinguishing between rectal syphilis and rectal cancer is extremely challenging without considering the patient's medical history. Rectal syphilis often leads to unnecessary tests or delayed treatment, as it can be mistaken for other benign diseases such as inflammatory bowel diseases in addition to rectal cancer. In this case report, we aim to provide a detailed report on the endoscopic, imaging, and pathological findings based on our experience with a case of suspected rectal malignancy that turned out to be rectal syphilis.
直肠梅毒是梅毒表现的一种罕见形式，其症状、内镜及影像学表现均无特异性。直肠梅毒通常表现为同心性直肠壁增厚、黏膜充血、直肠周围脂肪条索状影及淋巴结病等特征。直肠癌表现为不对称性肠壁增厚及淋巴结坏死，有助于这两种疾病的鉴别。然而，由于它们各自表现存在相当大的重叠，若不考虑患者病史，区分直肠梅毒和直肠癌极具挑战性。直肠梅毒常导致不必要的检查或治疗延误，因为它除了可被误诊为直肠癌外，还可能被误诊为其他良性疾病，如炎症性肠病。在本病例报告中，我们旨在根据我们对一例疑似直肠恶性肿瘤最终诊断为直肠梅毒的病例经验，提供一份关于内镜、影像学及病理表现的详细报告。
