A Case of Salmonella Infection in the Terminal Ileum That Was Initially Misdiagnosed as Lymphoma / 대한소화기내시경학회지

Salmonella usually invades the Peyer's patch of the terminal ileum or ascending colon. A 55-year old female was referred to our hospital for general weakness and sustained fever. On the abdominal contrast computed tomography (CT) scan, we found symmetric circular hypertrophy of the intestinal wall and multiple hypertrophied lymph nodes in the terminal ileum. The positron emission tomography computed tomography (PET-CT) scan showed skipped areas of wall thickening and intense fluorodeoxyglucose (FDG) uptake in the terminal ileum and the ileocecal valve with adjacent lymphadenopathies. On the colonoscopy, multiple mass forming variable-sized ulcers on the terminal ileum were found, so a biopsy specimen and the colonic luminal fluid were obtained, and we made a diagnosis of lymphoma. However, the blood and colonic luminal fluid culture for Salmonella paratyphi-A was reported as positive, and therefore we corrected the diagnosis to Salmonella infection. We report here on a case of Salmonella infection in the terminal ileum, which looked like malignant lymphoma on the baseline radiologic image studies, including the CT and PET-CT.

A case of primary ovarian leiomyoma / 부인종양

Ovarian leiomyoma is a rare type of tumor that only takes about 1% of benign ovarian tumor. It mostly does not induce any symptoms and is often found by chance during a surgical operation in abdominal cavity. It is microscopically observed that smooth muscle cells with an identical shape and a small nucleus grow in a bundle or in a storiform configuration, and they need to be distinguished from other tumors of the smooth-muscle origin that can occur in ovary such as fibroma/thecoma and extragastrointestinal stromal tumor. Using immunohistochemistry staining on desmin, smooth muscle actin (SMA), alpha-inhibin, c-kit, etc can help with distinguishing these tumors. Recently, the authors experienced in this hospital a primary ovarian leiomyoma of a 43-year-old female patient and hereby report the case with a review of literatures.