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Results for “TUBERCULOSIS, GASTROINTESTINAL”
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Hypertrophic tuberculosis of the rectum.
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Role of colonoscopic biopsy in distinguishing between Crohn's disease and intestinal tuberculosis.
BACKGROUND: The histological differential diagnosis of Crohn's disease and intestinal tuberculosis can be very challenging, as both are chronic granulomatous disorders with overlapping histological features. AIM: To evaluate selected clinical and histological parameters in colonic biopsy specimens for their ability to discriminate between Crohn's disease and intestinal tuberculosis. METHODS: 25 patients with Crohn's disease and 18 patients with intestinal tuberculosis were selected for this study on the basis of established clinical, radiological and histological criteria. Clinical data and selected histological parameters in colonoscopic biopsy specimens were assessed retrospectively. A total of 103 and 41 biopsy sites were evaluated in patients with Crohn's disease and intestinal tuberculosis, respectively. RESULTS: Clinical parameters helpful in differentiating intestinal tuberculosis from Crohn's disease included chest radiographic features of tuberculosis (56% v 0%), perianal fistulae (0% v 40%) and extraintestinal manifestations of Crohn's disease (0% v 40%). Histopathological features that seemed to reliably differentiate between intestinal tuberculosis and Crohn's disease included confluent granulomas, > or =10 granulomas per biopsy site and caseous necrosis (in biopsy samples of 50%, 33% and 22% of patients with intestinal tuberculosis, respectively, v 0% of patients with Crohn's disease). Features that were observed more often in patients with intestinal tuberculosis than in those with Crohn's disease included granulomas exceeding 0.05 mm(2) (67% v 8%), ulcers lined by conglomerate epithelioid histiocytes (61% v 8%) and disproportionate submucosal inflammation (67% v 10%). CONCLUSION: Clinical features and selected histological parameters in colonoscopic biopsy specimens can help in differentiating between Crohn's disease and intestinal tuberculosis.
Pathology of tropical appendicitis.
Over the past 25 years, 2921 appendicectomies were performed at this hospital. All were subjected to routine histopathological examination. In 95% of cases, histopathological examination did not add any further information but in 153 (5%) cases, clinically important pathological findings were detected for the first time. Seventy (2.3%) specimens showed typical evidence of tuberculosis. Parasitic infestation was detected in 75 (2.5%), including enterobiasis (1.4%), amoebiasis (0.5%), ascariasis (0.5%), ascariasis with trichuriasis (0.05%), and taeniasis (0.05%). Other lesions found were mucocele (0.1%) and carcinoid tumour (0.1%). It is concluded that routine histopathological examination of all appendicectomy specimens should be performed to avoid missing any clinically important and treatable condition.
A forgotten cause of abdominal pain.
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A rare cause for recurrent cystitis.
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Colonic tuberculosis.
A case of tuberculosis of the colon is described. Attention is drawn to the similarity between this and other inflammatory diseases of the bowel. Colonic tuberculosis is now a rarity even where mycobacterial infection is endemic, and may mimic other inflammatory diseases of the bowel with important consequences for treatment and prognosis. Such a case is now described.
Peritoneal biopsy for diagnosis of abdominal tuberculosis.
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Tuberculous perforation of the small bowel.
Small bowel perforation occurs in up to 2 percent of patients with abdominal tuberculous. Patients present with an acute abdomen. Resection of the diseased segment and 18 months treatment with anti-tuberculosis drugs is recommended.
Ileal carcinoma and tuberculous ileitis.
A 76 year old woman presented with abdominal pain and weight loss. At laparotomy she was found to have an adenocarcinoma of the ileum arising in a segment of tuberculous ileitis. The possible significance of this association is discussed.
Isolated colonic tuberculosis.
Two cases of isolated colonic tuberculosis are reported, and recent literature on this field is reviewed. Isolated colonic tuberculosis is defined as a tuberculosis which exists in the colon except for ileocaecum, without focus in any other organ. The morphological changes are tuberculous granulation primarily located to the submucosa layer of the colon with smooth surfaces of both mucous and serous membrane. Its clinical features are atypical, just like those on X-ray examination, and even on frozen biopsy, it may sometimes be misdiagnosed. The treatment of choice is resecting the diseased segment of colon combined with anti-tuberculosis therapy.
Tuberculosis of the appendix--a report of 17 cases and a suggested aetiopathological classification.
Tuberculosis of the appendix is rare. It is usually secondary to tuberculosis elsewhere in the abdomen. Tuberculosis of the appendix is not associated with any specific clinical features and diagnosis is revealed only after histopathological examination. Appendicectomy should be performed in all patients with abdominal tuberculosis subjected to laparotomy and all surgically removed appendices should be subjected to histopathological examination.
Pyloric obstruction due to gastric tuberculosis--an endoscopic diagnosis.
A 22 year old male presented with symptoms of gastric outlet obstruction. Endoscopy showed a hypertrophic nodular lesion around the pyloric opening with pyloric stenosis. The endoscopic biopsy and histopathological examination revealed tuberculosis involving the stomach, an extremely rare lesion.
Duodenal tuberculosis--a continuing diagnostic challenge.
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A new hypothesis for the aetiology of Crohn's disease--evidence from lipid metabolism and intestinal tuberculosis.
The stimulus for the immune response in Crohn's disease is unknown. In each of 19 cases of Crohn's disease evaluated by electron microscopy, epithelial cells of the ileum contained phagolysosomes with lamellar layers of lipid. These structures, now termed R or reactant bodies, are the proffered antigenic stimulus. They are proposed to be an amalgam of lipid (cholesterol esters, or phospholipids) and bacterial fragments (mycoplasma, mycobacteria or streptococci), which in combination are hypothesized to produce a powerful immunological response analogous to the adjuvant effect. For disease expression to occur, lipids and specific bacterial populations are needed in the bowel lumen. These factors may account for the success of elemental diets that are low in fat in the treatment of Crohn's disease and for the regional distribution of disease along the intestinal tract.
Colonic tuberculosis with colonic carcinoma--a rare association.
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Primary tuberculous appendicitis.
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