A Case of Gastric Tuberculosis with Suspected Gastric Submucosal Tumor before Operation

Hisao Kano, Kenji Mimatsu, Hide Kaneda, Youichi Kuboi, Takatsugu Oida and Sadao Amano*

Department of Surgery, Yokohama Central Hospital
First Department of Surgery, Nihon University School of Medicine*

A 79-years-old man diagnosed with gastric tuberculosis after partial gastrectomy had been preoperative diagnosed with a submucosal gastric tumor. His history included pulmonary tuberculosis 49 years earlier and, partial resection of the right lung. Recurrence was not occurred. His chief symptoms were slight fever and abdominal pain. Conservative therapy reduced the abdominal pain, but inflammation set in and, c-reactive protein was positive. The patient was followed as diagnosed fever unknown origin. Gastrointestinal fiberscopy showed a submucosal gastric tumor on the upper front of stomach, sized 4×4 cm. Local gastrectomy was performed under a diagnosis of gastric submucosal tumor (SMT). Pus from the SMT was not positive by culture. Histologically, the resected specimen consisted of caseating necrosis, mature epitheloid cells and Langhans' giant cells. From these findings, we diagnosed secondary gastric tuberculosis, which is rare. The patient was successfully treated by minimum surgical therapy.

Key words
gastric tuberculosis, submucosal gastric tumor

Reprint requests
Hisao Kano Department of Surgery, Yokohama Central Hospital
268 Yamashita-cho, Naka-ku, Yokohama, 231-8553 JAPAN

Accepted
April 28, 2004

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