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

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.