A Case of Colonic Tuberculosis with Verified Mycobacterium Tuberculosis from Colonoscopic Biopsy Specimen

Abstract

A 77-year-old woman was admitted to the Tokyo Medical College Hospital, because of her loss of body weight. Laboratory data on admission day revealed anemia and hypoalbuminemia, suggesting gastrointestinal (GI) bleeding. Upper GI endoscopy did not show any particular abnormalities. Barium enema examination revealed a stenotic lesion with irregular mucosal findings such as niches or barium spots on the transverse colon. Colonoscopy also revealed circular strictures combining with inflammatory polyps and multiple shallow ulcers with edematous margin and spotty bleeding on the middle transverse colon. Biopsy specimens taken only showed granulation tissue from ulcer base histologically. After the biopsy results, radiographic and endoscopic findings were reinvestigated. And for suspecting colonic tuberculosis, biopsy specimen was examined by Ziehl-Neelsen's staining. The diagnosis of tuberculosis was confirmed by detecting acid-fast bacilli from those specimen.
The definite diagnosis of colonic tuberculosis is usually made by histological confirmation of granulomatous inflammation with caseation necrosis and rarely by detection of Mycobacterium tuberculosis from colonoscopic biopsy specimen. This is the 8th case-report in Japan.