Colonic Tuberculosis Mimicking Colonic Cancer: A Multidisciplinary Diagnosis and Case Report

Fekade Yerakley Lucas; Abraham Kassahun Tadele; Ghion Getnet Engida; Teketel Tadesse Geremew; Abebaw Amare Wodajo; Melaku Teshale Gemechu; Menberu Moges Ayele; Kalkidan Molla Tegengne; Akmel Umer Ebrahim; Tigist Gutema Tesgera

doi:doi:10.11648/j.ajlm.20240904.11

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Colonic Tuberculosis Mimicking Colonic Cancer: A Multidisciplinary Diagnosis and Case Report

Fekade Yerakley Lucas

, Abraham Kassahun Tadele

, Ghion Getnet Engida

, Teketel Tadesse Geremew^*

, Abebaw Amare Wodajo

, Melaku Teshale Gemechu

, Menberu Moges Ayele

, Kalkidan Molla Tegengne

, Akmel Umer Ebrahim

, Tigist Gutema Tesgera

Published in American Journal of Laboratory Medicine (Volume 9, Issue 4)

Received: 31 August 2024 Accepted: 19 September 2024 Published: 29 September 2024

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Abstract

Gastrointestinal tuberculosis accounts for 1% to 3 % of all TB cases worldwide. Colonic tuberculosis is rare and can be mistaken for malignancy. It commonly presents as chronic abdominal pain along with night sweats, diarrhea, and fatigue and can resemble variety of other diseases making the diagnosis difficult. It presents with vague clinical and radiological picture making the diagnosis challenging for the clinicians. Its diagnosis is usually made by combining clinical features, radiological, tissue AFP staining and histopathologal examinations. The typical histopathologic findings include confluent large granulomas and langhans giant cells with caseating necrosis. Gastrointestinal tuberculosis responds well to standard antituberculous drugs and surgery is done for patients that have complications like strictures or obstruction which does not respond to medical therapy. This case illustrates a 40 year old man who presented with crampy lower abdominal pain and diagnosed as a colonic cancer both on imaging and clinically which later found to have colonic tuberculosis on a colectomy histopathologic sample. He was treated with anti-TB and respond well to his treatment. This case will give an insight for treating physicians to have a high index of suspicion for colonic TB in a patient who presented with lower abdominal pain and having colonic mass.

Published in	American Journal of Laboratory Medicine (Volume 9, Issue 4)
DOI	10.11648/j.ajlm.20240904.11
Page(s)	41-44
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Colon, Tuberculosis, Carcinoma

References

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[2]	Chakinala RC, Khatri AM. Gastrointestinal Tuberculosis. Stat Pearls. Treasure Island (FL): StatPearls Publishing, 2021.
[3]	Uma Debi, Vasudevan Ravisankar, Kaushal Kishor Prasad, Saroj Kant Sinha, Arun Kumar Sharma World journal of gastroenterology, Abdominal tuberculosis of gastrointestinal tract: 2014, 14832-14839.
[4]	Alvares JF, Devarbhavi H, Makhija P, Rao S, Kottoor R: Clinical, colonoscopic, and histological profile of colonic tuberculosis in a tertiary hospital. Endoscopy; 2005; 37(4): 351–6.
[5]	Elroy Patrick Weledji and Benjamin Thumamo Pokam, Abdominal tuberculosis: Is there a role for surgery? World journal of gastroenterology 2017; 174-181.
[6]	American Thoracic Society C, Infectious Diseases Society of America Treatment of tuberculosis. 2003; 52: 1–77.
[7]	Lau CF, et al. A case of colonic tuberculosis mimicking Crohn's disease. Hong Kong Medical Journal 4(1998): 63-66.
[8]	Yun Jung Lee, Suk-Kyun Yang, Seung Jae Myung, “The usefulness of colonoscopic biopsy in the diagnosis of intestinal tuberculosis and pattern of concomitant extra-intestinal tuberculosis” The Korean journal of gastroenterology, vol. 44, no. 3, pp. 153-159, 2004.
[9]	Lowbridge, C., Fadhil, S. A. M., Krishnan, G. D. et al. How can gastro-intestinal tuberculosis diagnosis be improved? A prospective cohort study. BMC Infect Dis 20, 255(2020).
[10]	R. S. Wiener, P. Della-Latta, and N. W. Schluger, “Effect of nucleic acid amplification for Mycobacterium tuberculosis on clinical decision making in suspected extrapulmonary tuberculosis,” Chest, vol. 128, no. 1, pp. 102–107, 2005.
[11]	Dong Ho Lee, MD, Young Tae Ko, MD, Yup Yoon, MD, Jae Hoon Lim, MD: Sonographic Findings of Intestinal Tuberculosis: 537-540.
[12]	S. Mukewar, R. Ravi, and A. Prasad, “Colon tuberculosis: endoscopic features and prospective endoscopic follow-up after anti-tuberculosis treatment,” Clinical and Translational Gastroenterology, vol. 3, 24 pages, 2012.
[13]	P. B. Tripathi and A. D. Amarapurkar, “Morphological spectrum of gastrointestinal tuberculosis, Trop Gastroenterology”, Vol, 30, no. 1, pp. 35-39, 2009.

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Plain Text BibTeX RIS

APA Style

Lucas, F. Y., Tadele, A. K., Engida, G. G., Geremew, T. T., Wodajo, A. A., et al. (2024). Colonic Tuberculosis Mimicking Colonic Cancer: A Multidisciplinary Diagnosis and Case Report. American Journal of Laboratory Medicine, 9(4), 41-44. https://doi.org/10.11648/j.ajlm.20240904.11

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ACS Style

Lucas, F. Y.; Tadele, A. K.; Engida, G. G.; Geremew, T. T.; Wodajo, A. A., et al. Colonic Tuberculosis Mimicking Colonic Cancer: A Multidisciplinary Diagnosis and Case Report. Am. J. Lab. Med. 2024, 9(4), 41-44. doi: 10.11648/j.ajlm.20240904.11

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AMA Style

Lucas FY, Tadele AK, Engida GG, Geremew TT, Wodajo AA, et al. Colonic Tuberculosis Mimicking Colonic Cancer: A Multidisciplinary Diagnosis and Case Report. Am J Lab Med. 2024;9(4):41-44. doi: 10.11648/j.ajlm.20240904.11

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@article{10.11648/j.ajlm.20240904.11,
  author = {Fekade Yerakley Lucas and Abraham Kassahun Tadele and Ghion Getnet Engida and Teketel Tadesse Geremew and Abebaw Amare Wodajo and Melaku Teshale Gemechu and Menberu Moges Ayele and Kalkidan Molla Tegengne and Akmel Umer Ebrahim and Tigist Gutema Tesgera},
  title = {Colonic Tuberculosis Mimicking Colonic Cancer: A Multidisciplinary Diagnosis and Case Report
},
  journal = {American Journal of Laboratory Medicine},
  volume = {9},
  number = {4},
  pages = {41-44},
  doi = {10.11648/j.ajlm.20240904.11},
  url = {https://doi.org/10.11648/j.ajlm.20240904.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajlm.20240904.11},
  abstract = {Gastrointestinal tuberculosis accounts for 1% to 3 % of all TB cases worldwide. Colonic tuberculosis is rare and can be mistaken for malignancy. It commonly presents as chronic abdominal pain along with night sweats, diarrhea, and fatigue and can resemble variety of other diseases making the diagnosis difficult. It presents with vague clinical and radiological picture making the diagnosis challenging for the clinicians. Its diagnosis is usually made by combining clinical features, radiological, tissue AFP staining and histopathologal examinations. The typical histopathologic findings include confluent large granulomas and langhans giant cells with caseating necrosis. Gastrointestinal tuberculosis responds well to standard antituberculous drugs and surgery is done for patients that have complications like strictures or obstruction which does not respond to medical therapy. This case illustrates a 40 year old man who presented with crampy lower abdominal pain and diagnosed as a colonic cancer both on imaging and clinically which later found to have colonic tuberculosis on a colectomy histopathologic sample. He was treated with anti-TB and respond well to his treatment. This case will give an insight for treating physicians to have a high index of suspicion for colonic TB in a patient who presented with lower abdominal pain and having colonic mass. 
},
 year = {2024}
}

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TY  - JOUR
T1  - Colonic Tuberculosis Mimicking Colonic Cancer: A Multidisciplinary Diagnosis and Case Report

AU  - Fekade Yerakley Lucas
AU  - Abraham Kassahun Tadele
AU  - Ghion Getnet Engida
AU  - Teketel Tadesse Geremew
AU  - Abebaw Amare Wodajo
AU  - Melaku Teshale Gemechu
AU  - Menberu Moges Ayele
AU  - Kalkidan Molla Tegengne
AU  - Akmel Umer Ebrahim
AU  - Tigist Gutema Tesgera
Y1  - 2024/09/29
PY  - 2024
N1  - https://doi.org/10.11648/j.ajlm.20240904.11
DO  - 10.11648/j.ajlm.20240904.11
T2  - American Journal of Laboratory Medicine
JF  - American Journal of Laboratory Medicine
JO  - American Journal of Laboratory Medicine
SP  - 41
EP  - 44
PB  - Science Publishing Group
SN  - 2575-386X
UR  - https://doi.org/10.11648/j.ajlm.20240904.11
AB  - Gastrointestinal tuberculosis accounts for 1% to 3 % of all TB cases worldwide. Colonic tuberculosis is rare and can be mistaken for malignancy. It commonly presents as chronic abdominal pain along with night sweats, diarrhea, and fatigue and can resemble variety of other diseases making the diagnosis difficult. It presents with vague clinical and radiological picture making the diagnosis challenging for the clinicians. Its diagnosis is usually made by combining clinical features, radiological, tissue AFP staining and histopathologal examinations. The typical histopathologic findings include confluent large granulomas and langhans giant cells with caseating necrosis. Gastrointestinal tuberculosis responds well to standard antituberculous drugs and surgery is done for patients that have complications like strictures or obstruction which does not respond to medical therapy. This case illustrates a 40 year old man who presented with crampy lower abdominal pain and diagnosed as a colonic cancer both on imaging and clinically which later found to have colonic tuberculosis on a colectomy histopathologic sample. He was treated with anti-TB and respond well to his treatment. This case will give an insight for treating physicians to have a high index of suspicion for colonic TB in a patient who presented with lower abdominal pain and having colonic mass. 

VL  - 9
IS  - 4
ER  -

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Author Information

Fekade Yerakley Lucas

Department of Pathology, Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia

http://orcid.org/0009-0006-5239-0858
Abraham Kassahun Tadele

Department of Pathology, Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia

http://orcid.org/0000-0002-5822-0052
Ghion Getnet Engida

Department of Pathology, Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia

http://orcid.org/0000-0002-1059-1129
Teketel Tadesse Geremew

Department of Pathology, Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia

Contact Email

http://orcid.org/0009-0005-1691-8507
Abebaw Amare Wodajo

Department of Pathology, Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia

http://orcid.org/0000-0001-9280-7351
Melaku Teshale Gemechu

Department of Surgery, Wendogenet Primary Hospital, Wendogenet, Ethiopia

http://orcid.org/0000-0001-7672-947X
Menberu Moges Ayele

Department of Internal Medicine, Wachemo University, Hossana, Ethiopia

http://orcid.org/0009-0004-8213-6282
Kalkidan Molla Tegengne

Department of Internal Medicine, Arbaminch University of College of Medicine and Health Science, Arbaminch, Ethiopia

http://orcid.org/0009-0001-3167-5663
Akmel Umer Ebrahim

Department of Pathology, Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia

http://orcid.org/0009-0006-4218-7303
Tigist Gutema Tesgera

Department of Internal Medicine, Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia

http://orcid.org/0009-0009-4050-8582

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Plain Text BibTeX RIS

APA Style

Lucas, F. Y., Tadele, A. K., Engida, G. G., Geremew, T. T., Wodajo, A. A., et al. (2024). Colonic Tuberculosis Mimicking Colonic Cancer: A Multidisciplinary Diagnosis and Case Report. American Journal of Laboratory Medicine, 9(4), 41-44. https://doi.org/10.11648/j.ajlm.20240904.11

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ACS Style

Lucas, F. Y.; Tadele, A. K.; Engida, G. G.; Geremew, T. T.; Wodajo, A. A., et al. Colonic Tuberculosis Mimicking Colonic Cancer: A Multidisciplinary Diagnosis and Case Report. Am. J. Lab. Med. 2024, 9(4), 41-44. doi: 10.11648/j.ajlm.20240904.11

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AMA Style

Lucas FY, Tadele AK, Engida GG, Geremew TT, Wodajo AA, et al. Colonic Tuberculosis Mimicking Colonic Cancer: A Multidisciplinary Diagnosis and Case Report. Am J Lab Med. 2024;9(4):41-44. doi: 10.11648/j.ajlm.20240904.11

Copy | Download

@article{10.11648/j.ajlm.20240904.11,
  author = {Fekade Yerakley Lucas and Abraham Kassahun Tadele and Ghion Getnet Engida and Teketel Tadesse Geremew and Abebaw Amare Wodajo and Melaku Teshale Gemechu and Menberu Moges Ayele and Kalkidan Molla Tegengne and Akmel Umer Ebrahim and Tigist Gutema Tesgera},
  title = {Colonic Tuberculosis Mimicking Colonic Cancer: A Multidisciplinary Diagnosis and Case Report
},
  journal = {American Journal of Laboratory Medicine},
  volume = {9},
  number = {4},
  pages = {41-44},
  doi = {10.11648/j.ajlm.20240904.11},
  url = {https://doi.org/10.11648/j.ajlm.20240904.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajlm.20240904.11},
  abstract = {Gastrointestinal tuberculosis accounts for 1% to 3 % of all TB cases worldwide. Colonic tuberculosis is rare and can be mistaken for malignancy. It commonly presents as chronic abdominal pain along with night sweats, diarrhea, and fatigue and can resemble variety of other diseases making the diagnosis difficult. It presents with vague clinical and radiological picture making the diagnosis challenging for the clinicians. Its diagnosis is usually made by combining clinical features, radiological, tissue AFP staining and histopathologal examinations. The typical histopathologic findings include confluent large granulomas and langhans giant cells with caseating necrosis. Gastrointestinal tuberculosis responds well to standard antituberculous drugs and surgery is done for patients that have complications like strictures or obstruction which does not respond to medical therapy. This case illustrates a 40 year old man who presented with crampy lower abdominal pain and diagnosed as a colonic cancer both on imaging and clinically which later found to have colonic tuberculosis on a colectomy histopathologic sample. He was treated with anti-TB and respond well to his treatment. This case will give an insight for treating physicians to have a high index of suspicion for colonic TB in a patient who presented with lower abdominal pain and having colonic mass. 
},
 year = {2024}
}

Copy | Download

TY  - JOUR
T1  - Colonic Tuberculosis Mimicking Colonic Cancer: A Multidisciplinary Diagnosis and Case Report

AU  - Fekade Yerakley Lucas
AU  - Abraham Kassahun Tadele
AU  - Ghion Getnet Engida
AU  - Teketel Tadesse Geremew
AU  - Abebaw Amare Wodajo
AU  - Melaku Teshale Gemechu
AU  - Menberu Moges Ayele
AU  - Kalkidan Molla Tegengne
AU  - Akmel Umer Ebrahim
AU  - Tigist Gutema Tesgera
Y1  - 2024/09/29
PY  - 2024
N1  - https://doi.org/10.11648/j.ajlm.20240904.11
DO  - 10.11648/j.ajlm.20240904.11
T2  - American Journal of Laboratory Medicine
JF  - American Journal of Laboratory Medicine
JO  - American Journal of Laboratory Medicine
SP  - 41
EP  - 44
PB  - Science Publishing Group
SN  - 2575-386X
UR  - https://doi.org/10.11648/j.ajlm.20240904.11
AB  - Gastrointestinal tuberculosis accounts for 1% to 3 % of all TB cases worldwide. Colonic tuberculosis is rare and can be mistaken for malignancy. It commonly presents as chronic abdominal pain along with night sweats, diarrhea, and fatigue and can resemble variety of other diseases making the diagnosis difficult. It presents with vague clinical and radiological picture making the diagnosis challenging for the clinicians. Its diagnosis is usually made by combining clinical features, radiological, tissue AFP staining and histopathologal examinations. The typical histopathologic findings include confluent large granulomas and langhans giant cells with caseating necrosis. Gastrointestinal tuberculosis responds well to standard antituberculous drugs and surgery is done for patients that have complications like strictures or obstruction which does not respond to medical therapy. This case illustrates a 40 year old man who presented with crampy lower abdominal pain and diagnosed as a colonic cancer both on imaging and clinically which later found to have colonic tuberculosis on a colectomy histopathologic sample. He was treated with anti-TB and respond well to his treatment. This case will give an insight for treating physicians to have a high index of suspicion for colonic TB in a patient who presented with lower abdominal pain and having colonic mass. 

VL  - 9
IS  - 4
ER  -

Copy | Download