Korean J Helicobacter Up Gastrointest Res.  2018 Mar;18(1):65-69. 10.7704/kjhugr.2018.18.1.65.

Tuberculous Lymphadenitis Mimicking Gastric Subepithelial Tumor Diagnosed Using Endoscopic Ultrasound-guided Fine-needle Aspiration

• Kim SB
• Kim TN
• Kim KH

• KMID: 2428902
• DOI: http://doi.org/10.7704/kjhugr.2018.18.1.65

Abstract

A gastric subepithelial tumor (SET) is commonly detected during a diagnostic endoscopic examination. Gastric tuberculosis (TB), in particular, can present as a SET of the gastric wall. A few cases of gastric TB mimicking a SET have recently been reported. Radiological imaging combined with endoscopic biopsy can aid in the early diagnosis of TB without surgical intervention. A 41-year-old man visited our health promotion center for a regular check-up. Esophagogastroduodenoscopy (EGD) revealed a round and smooth, bulging mucosal lesion suggesting a gastric SET in the upper body of the stomach. Endoscopic ultrasound (EUS) demonstrated a hypoechoic lesion measuring 18 mm, with an obscure layer of origin, and EUS-guided fine-needle aspiration was performed. Microscopic examination of the sample showed chronic granulomatous inflammation. Histopathologically, the aspirated sample showed positive Ziehl-Neelsen staining, confirming a diagnosis of tuberculous lymphadenitis. We describe a case of a patient who presented with tuberculous lymphadenitis mimicking a SET of the stomach. The lesion was found on EGD and confirmed using EUS-guided fine-needle aspiration.

Keyword

Endoscopic ultrasound; Endoscopic ultrasound-guided fine-needle aspiration; Subepithelial tumor; Tuberculosis

MeSH Terms

Adult
Biopsy
Biopsy, Fine-Needle*
Diagnosis
Early Diagnosis
Endoscopy, Digestive System
Health Promotion
Humans
Inflammation
Stomach
Tuberculosis
Tuberculosis, Lymph Node*
Ultrasonography