A case of colonic cancer in the ascending colon associated with intestinal tuberculosis

Abstract

85-year-old woman was admitted to our hospital because of anemia and fecal occult blood. Blood test showed iron deficiency anemia (Hb 7.5 g/dl) and negative for T-SPOT. Acid-fast bacillus in the gastric juice was negative. Barium enema showed shortening from the cecum to the descending colon, pseudodiverticulum and atrophic scars in the ascending colon, stenosis in the ileocecal valve, the sigmoid colon, the terminal ileum, and the transverse colon. Colonoscopic findings showed irregular circular ulcers in the terminal ileum, stenosis in the ileocecal valve, and multiple ulcer scars in the ascending colon, and irregular ulcer and flat elevated lesions around the ulcer in the transverse colon. The pathological findings of biopsy specimens showed tubular adenocarcinoma in the transverse colon and chronic inflammation without granuloma in the terminal ileum and ascending colon. Acid-fast bacillus for biopsy specimens was negative. Laparoscopic right hemicolectomy was performed. The depth of the colonic cancer was the subserosa without lymph node metastasis. The flat elevated lesion surrounding the cancer was not dysplasia but hyperplastic change. Based on these data, intestinal tuberculosis was suspected. We reported a rare case of colonic cancer associated with intestinal tuberculosis.