A CASE OF GASTRIC SYPHILIS CONFIRMED BY DEMONSTRATION OF TREPONEMA PALLIDUM WITH GRANULOMATOUS CHANGES

Abstract

A case of gastric syphilis confirmed by demonstration of Treponema pallidum as well as granulomatous change from biopsy specimen was reported. A 26-year-old male with a chief complaint of epigastric pain was admitted to our hospital with a suspicion of Borrmann IV gastric cancer. X-ray examination revealed rigidity of the wall and poor distensibility of the lumen from the lower part of the gastric body to the pyloric antrum. Endoscopic examination demonstrated various-sized, numerous protuberances and irregular shallow erosions with marked friability in the abnormal area detected by X-ray examination. Abdominal CT showed remarkable thickening of the walls in the lower half of the stomach. A granuloma consisting of several Langhans giant cells was found and no malignancy was demonstrated in the gastric biopsy specimen. In addition to these findings, a diagnosis of gastric syphilis was strongly suspected from positive serologic test for syphilis. A diagnosis of gastric syphilis was confirmed by the demonstration of Treponema pallidum by silver staining and electron microscopic examination of biopsy specimen. Antibiotic treatment was administered. The symptoms were improved a few days later, and X-ray and endoscopic abnormalities almost disappeared approximately two months later.