Ganglionar tuberculosis post tumor resection case report

The presentation of lymphatic tuberculosis in the pelvic area is relatively uncommon which makes diagnosis even more difficult especially in the context of cancer patients This case report demonstrate a patient with previous diagnosis of adenocarcinoma of the colon pT pN PMX who underwent rectosigmoidectomy A few months after the patient complained of weight loss and loss of appetite which led investigation of recurrence or metastasis In order to clarify the changes in clinical patient a CT Positron Emission has been requested which showed brightness of images in the pelvic region indicative of lymph node metastasis A pelvic lymphadenectomy was conducted showing a fibrofatty tissue exhibiting steatonecrosis fibrosis and mild inflammation foci with no atypical cells in the sample The tuberculin skin test was used with a strong result mm x mm confirming the diagnosis the patient was then treated with the RIPE scheme RIF INH PZA ethambutol resulting in improvement of the symptoms The differential diagnosis of abdominal lymphadenopathy in a patient after tumor resection involves examining the colon PET scans to assess the avidity of body tissues to capture positrons However it is known that PET scans and conventional CT scan detect changes resulting from malignancies such as lymphomas and tumor recurrences is able to show lymphadenopathy arising from lymphatic tuberculosis due to the presence of inflammatory cells In conclusion it should be considered that patients treated or follow diagnosed with cancer are more likely to tuberculosis than the normal population and therefore positive results of PET scans should be interpreted with caution in the differentiation of benign and malignant lesions especially in regions with high prevalence of tuberculosis and must be confirmed by pathological examination before the start of definitive treatment