Korean Journal of Gastrointestinal Endoscopy 2009;39(6): 384-388.
림프종으로 오인된 회장 말단부의 살모넬라 감염증
채명훈ㆍ김문영ㆍ이진형ㆍ권용환ㆍ박소연ㆍ조미연*ㆍ정요셉*ㆍ차승환†
연세대학교 원주의과대학 내과학교실, *병리학교실, †영상의학교실
A Case of Salmonella Infection in the Terminal Ileum That Was Initially Misdiagnosed as Lymphoma
Myeong Hun Chae, M.D., Moon Young Kim, M.D., Jin Hyung Lee, M.D., Yong Hwan Kwon, M.D., So Yeon Park, M.D., Mee Yon Cho, M.D.*, Yo Sep Chong, M.D.* and Seung Whan Cha, M.D.†
Departments of Internal Medicine, *Pathology and †Radiology, Yonsei University Wonju College of Medicine, Wonju, Korea
Abstract
Salmonella usually invades the Peyer's patch of the terminal ileum or ascending colon. A 55-year old female was referred to our hospital for general weakness and sustained fever. On the abdominal contrast computed tomography (CT) scan, we found symmetric circular hypertrophy of the intestinal wall and multiple hypertrophied lymph nodes in the terminal ileum. The positron emission tomography computed tomography (PET-CT) scan showed skipped areas of wall thickening and intense fluorodeoxyglucose (FDG) uptake in the terminal ileum and the ileocecal valve with adjacent lymphadenopathies. On the colonoscopy, multiple mass forming variable-sized ulcers on the terminal ileum were found, so a biopsy specimen and the colonic luminal fluid were obtained, and we made a diagnosis of lymphoma. However, the blood and colonic luminal fluid culture for Salmonella paratyphi-A was reported as positive, and therefore we corrected the diagnosis to Salmonella infection. We report here on a case of Salmonella infection in the terminal ileum, which looked like malignant lymphoma on the baseline radiologic image studies, including the CT and PET-CT. (Korean J Gastrointest Endosc 2009;39:384-388)
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