ABSTRACT
Tubercle bacillus was discovered in 1882 by Robert Koch. With the introduction of chemotherapy for tuberculosis in the 1940s the incidence of this entity decreased. The incidence of the tuberculosis of the colon began to increase at the 1980s with the rise in numbers of patients considered as high risk for this entity, such as HIV-infected individuals, patients with chronic renal disease, and immunosuppressed patients with prolonged steroid therapy. We report on two patients with history of chronic abdominal pain and weight loss with a palpable mass in the right lower quadrant. In one patient chest radiography revealed a miliary reticulonodular pattern. In both, abdominal CT scan showed retroperitoneal lymphadenopathy and colonic wall thickness. Colonoscopic examination showed ulcerative lesions and ileocecal valve disruption. Microscopic examination of intestinal content showed evidenced M. tuberculosis. Tuberculosis of the colon should be suspected in patients suffering from chronic abdominal pain and weight loss.
Subject(s)
Colonic Diseases , Tuberculosis, Gastrointestinal , Abdominal Pain/etiology , Adult , Antitubercular Agents/therapeutic use , Colonic Diseases/diagnosis , Colonic Diseases/drug therapy , Colonic Diseases/epidemiology , Diagnosis, Differential , Female , Humans , Male , Risk Factors , Tuberculosis, Gastrointestinal/diagnosis , Tuberculosis, Gastrointestinal/drug therapy , Tuberculosis, Gastrointestinal/epidemiology , Weight LossABSTRACT
UNLABELLED: Primary colon lymphomas (PCL) are very rare tumors of the gastrointestinal tract, and represent 0.2-0.5% of all colon primary tumors. They appear principally PCL in adult population. Almost all are non-Hodgkin's lymphomas; first however, one must discard lymph node origin. The most frequent sites of presentation are the cecum and rectum. Treatment of choice is surgical, plus adjuvant chemotherapy. Radiotherapy is reserved for specific cases. OBJECTIVE: To inform on two cases of PCL. METHOD: Review two of cases of cecum lymphomas and their treatment. RESULTS: We inform the cases of two patients with the diagnosis of cecum lymphoma. The main patient complaints were abdominal pain, palpable mass, and hemorrhage. Both patients were treated with right extended hemicolectomy and ileum-transverse anastomosis. The outcome was unremarkable. Both patients received chemotherapy and remain free of disease at 1.5 and 5 years of follow-up. CONCLUSIONS: Primary colon lymphomas are very uncommon gastrointestinal tumors, with cecum localization as one of the most frequent sites of presentation in the colon. Treatment of choice must be surgical, with chemotherapy as an adjuvant therapy to improve survival.
Subject(s)
Colonic Neoplasms/therapy , Lymphoma/therapy , Adult , Aged , Female , Humans , MaleABSTRACT
Endoanal sonography can be used in the assessment of benign and malignant anal conditions and to evaluate the anatomy of the anal sphincters. We used endoanal sonography with a 10-MHz rotating endocavitary probe to evaluate a 45-year-old woman with a perianal mass, fecal incontinence, and menses-associated perianal pain. She had had 2 vaginal deliveries requiring episiotomies. Biopsy of the mass showed endometrial tissue. The ultrasound examination showed a perianal mass and an external anal sphincter injury. A wide excision and sphincteroplasty were performed, with improvement of fecal continence and pain. Histopathologic examination of the mass confirmed perianal endometrioma in an episiotomy scar.
