Case Report: A case of tuberculosis lymphadenitis mimicking a gastric tumor [version 1; peer review: 1 approved with reservations]

Solitary tuberculosis of the upper gastrointestinal tract is a rare pathology that usually mimics the clinical and radiological features of malignant tumors. A gastric subepithelial tumor is usually detected during diagnostic endoscopy. Stomach tuberculosis, in particular, can appear as a subepithelial tumor of the stomach wall. Several cases of gastric tuberculosis imitating subepithelial gastric tumors have been reported recently. We describe the case of a patient with tuberculous lymphadenitis that mimics a submucosal gastric tumor. A 52-year-old female was admitted to our surgical department for epigastric pain and weight loss. Endoscopy was inconclusive; it revealed either a submucosal compression or an anterior submucosal lesion with erosive anterior gastropathy and a fistulous orifice located in the bulb. The patient was diagnosed with a gastric tumor and an endoscopic ultrasound demonstrated a rounded hypoechogenic antral lesion that was not vascularized and was distant from the gastric wall, whose five layers appeared of a normal aspect. The patient underwent an exploratory laparotomy. A biopsy was sent intraoperatively for frozen section examination, and concluded that the diagnosis was tuberculous intraperitoneal lymphadenitis. The patient received anti-tuberculosis treatment. This case demonstrates that gastric tuberculosis remains a challenging diagnosis.