[Abdominal tuberculosis misdiagnosed as tumor]

Abstract

Objective: To evaluate the clinical and pathological features of abdominal tuberculosis (TB) in order to establish correct diagnosis.

Methods: Forty-five cases of abdominal TB, which were clinically misdiagnosed as tumor (misdiagnosed as malignant tumor in 31 cases) between 1962 and 1997 were reviewed. The diagnosis was confirmed histopathologically after the operation.

Results: Most of the patients with abdominal TB were young in age (< 40 years in 29 cases, 64%) and females (28 cases, 62%). The main clinical manifestations were abdominal mass (37 cases, 82%), abdominal pain (30 cases, 67%), fever (17 cases, 38%), abdominal distension, constipation or diarrhea (15 cases, 33%) and weight loss (14 cases, 29%). The finding during operation showed multiple massive lesions involving intestine, peritoneum and lymph nodes in all the cases, which mimicked those with abdominal tumor. Under microscopy, proliferative type of lesions were found in 29 cases, caseous necrosis type in 11 cases and mixed type in 5 cases.

Conclusions: It is showed that the clinical manifestations of abdominal TB mimic those in abdominal tumor. It is recommended that clinicians should improve understanding of clinical and pathological features of the abdominal TB and that exploratory laparotomy biopsy should be performed on those with suspected abdominal TB.