PMC10349567_01
Abdominal contrast-enhanced computed tomography showing thickening of the gastric body and antrum wall and exudation around the gastric antrum (Red arrow: lesion).
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Abdominal contrast-enhanced computed tomography showed thickening of the gastric body and antrum wall, exudation around the gastric antrum, and multiple lymphadenopathies in the abdominal cavity and retroperitoneum (Figure 1).
Gastroscopy showing multiple geographically irregular, partially fused ulcers extending from the gastric body to the pylorus. (A) Gastric angle (Red arrow: ulcers); (B) gastric antrum (Red arrow: ulcers).
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Gastroscopy revealed multiple geographically irregular, partially fused ulcers extending from the gastric body to the pylorus, and lymphoma could not be ruled out (Figure 2).  
HE staining showing a large number of plasma cells and a small amount of neutrophil infiltration in the intrinsic mucosa. (A) Low magnification (original magnification x100); (B) high magnification (original magnification x400) (Red arrows: plasma cells).
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As shown in Figure 3, neutrophils had infiltrated and destroyed the glands, resulting in cryptitis.
IHC analysis showing an abundance of syphilis spirochetes in the mucosal lamina propria and glands. (A) Low magnification (original magnification x100); (B) high magnification (original magnification x400) (Red arrows: syphilis spirochetes).
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However, T. pallidum immunohistochemistry (IHC) showed an abundance of syphilis spirochetes in the mucosal lamina propria and glands (Figure 4).  