title: Primary tuberculosis of the appendix in a young male patient: report of a case.
abstract: A 23-year-old man without a history of tuberculosis presented with right lower abdominal pain and a fever. An increased inflammatory response was found, and abdominal computed tomography showed a diffuse enlargement and wall thickening in the appendix. An ileocecal abscess and perforating appendicitis were suspected. Therefore, an emergency operation was performed. The surgery revealed a diffuse enlargement with adhesion to the retroperitoneum, which was suspected to be a neoplastic lesion of the appendix, thus an ileocecal resection including the appendix was performed. A histopathological examination revealed a number of epithelioid granulomas having Langerhans giant cells with caseous necrosis in the appendix, in addition to many granulomas without caseous necrosis in the regional lymph nodes. No tubercle bacilli were detected by Ziehl-Neelsen staining. Further examination revealed no tubercular lesions in other organs, thus leading to the diagnosis of primary tuberculosis of the appendix. This is an extremely rare disease reported in Japan.
authors.affiliation: Department of Surgery, Fukuoka Tokushukai Hospital, 4-5 Sukukita, Kasuga, Fukuoka, 816-0864, Japan.
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Ito
authors.forename: Shunji
authors.initials: S
authors.lastname: Kawamoto
authors.forename: Kazuo
authors.initials: K
authors.lastname: Inada
authors.forename: Shuji
authors.initials: S
authors.lastname: Nagao
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kanemaru
authors.forename: Naotaka
authors.initials: N
authors.lastname: Noda
authors.forename: Ryoji
authors.initials: R
authors.lastname: Ochiai
mesh_terms: D001065:Appendix / Q000382:microbiology / Q000473:pathology*; D002429:Cecal Diseases / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D014385:Tuberculosis, Gastrointestinal / Q000175:diagnosis / Q000601:surgery*; D055815:Young Adult