Case of extra-pulmonary tuberculosis mycobacterium mimicking a colon cancer

Abstract

Following initial consultation, urgent endoscopic and radiological investigations were organised. Computed Tomography (CT) imaging of the chest, abdomen, and pelvis identified a segment of irregular caecal and ascending colon wall thickening suggestive of primary colonic malignancy, with associated mesenteric lymph node involvement (figure 1). Indeterminate subpleural nodules and mediastinal lymph nodes with partial calcification were noted in the chest but deemed of limited relevance after discussion with the radiology team. Colonoscopy noted a malignant-looking stricture, measuring 5 cm, in the ascending colon (figure 2). Biopsies showed focal ulceration with non-necrotising granulomata, but no dysplastic or malignant cells were seen. Gastroscopy revealed only mild gastritis.