十二指腸直接浸潤をきたした腸間膜リンパ節結核の１例

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  • A Case of Tuberculous Mesenteric Lymphadenitis Presented with a Mass Penetrating the Duodenum.

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A 28-year-old woman complained of abdominal pain and lumbago and determined to have no gynecological lesions at a gynecological hospital was referred to the hospital in January 2001. When she was first seen, an elastic hard mass, about 6×5cm in diameter, was palpated in the right lower quadrant of abdomen. CT and MRI scans visualized a tumor spreading from the right side of the inferior versa cava to the ileocecal area, presumably originating from the mesentery or the postperitonium, while no lesions were detected by gastroduodenoscopy and colonoscopy. As we could not make definite preoperative diagnosis, an exploratory operation was performed on January 23. Surgical findings revealed that the lesion was an enlarged fist-sized lymph node on the mesentery of the ascending the colon. The tumor directly penetrated the duodenum, and intraoperative gastroduodenoscopy showed an invaded tumor in the second portion of the duodenum. Right hemicolectomy and a partial resection of the duodenum were carried out. Pathological study revealed that the tumor was tuberculous mesenteric lymphadenitis.Therefore administration of antituberculous drugs was started after the surgery.

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