Diffuse Long-segment Colonic Wall Thickening Mimicking Abdominal Tuberculosis: A Diagnostic Challenge Revealing Signet Ring Cell Carcinoma in a 24-year-old Male.
Sakshi Jeswani, Chetana Ratnaparkhi
✦ AI-curated · Sources linked
Case in brief
A 24-year-old man with long-standing abdominal pain had contrast-enhanced CT showing target-like diffuse bowel-wall thickening from the terminal ileum through the entire transverse colon, with ascites and omental thickening. The findings suggested abdominal tuberculosis, but CA 19-9 was markedly elevated at >1000 U/ml, leaving the distinction uncertain. Biopsy of the thickened bowel demonstrated signet ring cell carcinoma of the colon.
What made this case unusual
The diffuse, long-segment bowel thickening with ascites and omental involvement mimicked abdominal tuberculosis in a young patient, while biopsy established colonic signet ring cell carcinoma.
Diagnostic / clinical pearl
When diffuse bowel thickening and peritoneal involvement resemble tuberculosis, markedly elevated tumor markers should prompt investigation for malignancy; tissue biopsy can resolve the diagnostic uncertainty.