A case of intestinal tuberculosis with white submucosal tumor-like lesion

Abstract

We report a case of a 38-year-old man who complained of abdominal pain and was diagnosed with intestinal tuberculosis. Ileocolonoscopy revealed white submucosal tumor (SMT) -like lesion at the terminal ileum and cecum. A biopsy of a white SMT-like lesion revealed caseating granulomas on pathological examination. He was diagnosed with intestinal tuberculosis, and received antituberculous therapy. A combination of rifampicin, isoniazid, pyrazinamide, and ethambutol was used for 2 months, followed by a combination of rifampicin and isoniazid for 4 months.

Endoscopic findings of intestinal tuberculosis are typically ring-shaped and band-shaped erosions and ulcers, in contrast, SMT-like lesion are rare. According to the Kuromaru's classification (pathological classification of intestinal tuberculosis), the white SMT-like lesion is classified as an early image of tuberculosis. In fact, in this case, SMT-like lesion led to the diagnosis of intestinal tuberculosis. Therefore, although SMT-like lesion is rare as a finding of intestinal tuberculosis, it should be included in one of the differential diseases.