PMC6044367_01
An ulcerated mass in the hepatic flexure.
imcrj-11-151Fig1.jpg
PMC6044367_01_imcrj-11-151Fig1.jpg
f1-imcrj-11-151
As the endoscope could not pass through the hepatic flexure, the procedure was stopped (Figure 1).
The histology showed ulceration and granulation tissue formation, foci of necrotizing granulomatous inflammation in lamina propria with adjacent mild crypt regenerative changes (H&E, original magnification, 10x).
imcrj-11-151Fig2.jpg
PMC6044367_01_imcrj-11-151Fig2.jpg
f2-imcrj-11-151
The pathobiological features revealed ulceration and granulation tissue formation, foci of necrotizing granulomatous inflammation in lamina propria with adjacent mild crypt regenerative changes (Figure 2).
Acid-fast positive bacilli in the granuloma (Ziehl-Neelsen's stain, 100x).
imcrj-11-151Fig3.jpg
PMC6044367_01_imcrj-11-151Fig3.jpg
f3-imcrj-11-151
Moreover, Ziehl-Neelsen stained sections (Figure 3) revealed few acid-fast positive bacilli in the granuloma.
The chest X-ray showed no evidence of pulmonary involvement.
imcrj-11-151Fig4.jpg
PMC6044367_01_imcrj-11-151Fig4.jpg
f4-imcrj-11-151
ITB was negative. In order to rule out pulmonary TB, radiography was performed with no evidence of pulmonary involvement (Figure 4).