Mycobacterium tuberculosis
Laura W. Lamps, MD
Key Facts
Clinical Issues
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GI symptoms, rather than pulmonary, may be initial presentation
Macroscopic Features
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Frequency of involvement: Ileocecum > jejunoileum > appendix > ascending colon
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Endoscopic findings
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Ulcers
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Multiple &/or segmental involvement with skip areas
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Inflammatory nodules
Microscopic Pathology
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Caseating granulomas
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Associated rim of lymphocytes
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Acid-fast stains may demonstrate organisms
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Culture &/or molecular testing may be required
Hematoxylin & eosin stained biopsy shows confluent epithelioid granulomas  in the right colon. There are scattered multinucleate giant cells and associated lymphocytes. |
Hematoxylin & eosin stained section of an esophageal biopsy shows a palisading granuloma  with central caseous necrosis in the submucosa of the esophagus. (Courtesy P. Ferguson, MD.) |
TERMINOLOGY
Abbreviations
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Mycobacterium tuberculosis
Synonyms
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Tuberculosis (TB)
Definitions
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Granulomatous disease caused by acid-fast M. tuberculosis
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Common in developing countries
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Resurgence in developed countries due to AIDS, immigrant populations, overcrowding
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CLINICAL ISSUES
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