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Korean J Helicobacter  Up Gastrointest Res > Volume 18(1); 2018 > Article
The Korean Journal of Helicobacter  and Upper Gastrointestinal Research 2018;18(1):65-69.
DOI: https://doi.org/10.7704/kjhugr.2018.18.1.65    Published online March 10, 2018.
Tuberculous Lymphadenitis Mimicking Gastric Subepithelial Tumor Diagnosed Using Endoscopic Ultrasound-guided Fine-needle Aspiration
Sung Bum Kim, Tae Nyeun Kim, Kook Hyun Kim
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea. kimkh@yu.ac.kr
Correspondence:  Kook Hyun Kim, Tel: +82-53-620-3576, Fax: +82-53-654-8386, 
Email: kimkh@yu.ac.kr
Received: 30 September 2017   • Revised: 28 November 2017   • Accepted: 29 November 2017
Abstract
A gastric subepithelial tumor (SET) is commonly detected during a diagnostic endoscopic examination. Gastric tuberculosis (TB), in particular, can present as a SET of the gastric wall. A few cases of gastric TB mimicking a SET have recently been reported. Radiological imaging combined with endoscopic biopsy can aid in the early diagnosis of TB without surgical intervention. A 41-year-old man visited our health promotion center for a regular check-up. Esophagogastroduodenoscopy (EGD) revealed a round and smooth, bulging mucosal lesion suggesting a gastric SET in the upper body of the stomach. Endoscopic ultrasound (EUS) demonstrated a hypoechoic lesion measuring 18 mm, with an obscure layer of origin, and EUS-guided fine-needle aspiration was performed. Microscopic examination of the sample showed chronic granulomatous inflammation. Histopathologically, the aspirated sample showed positive Ziehl-Neelsen staining, confirming a diagnosis of tuberculous lymphadenitis. We describe a case of a patient who presented with tuberculous lymphadenitis mimicking a SET of the stomach. The lesion was found on EGD and confirmed using EUS-guided fine-needle aspiration.
Key Words: Endoscopic ultrasound; Endoscopic ultrasound-guided fine-needle aspiration; Subepithelial tumor; Tuberculosis


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