A diagnostic approach for differentiating abdominal tuberculosis from ovarian malignancy: a case series and literature review

Fahmi, Moh Nailul; Harti, Annisaa Pelita

doi:10.1186/s12919-019-0180-y

Cited by 11 publications

(12 citation statements)

References 36 publications

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“…ADA is a purine degrading enzyme that is essential for T lymphocyte proliferation and differentiation, a process that is necessary for the immune response against M tuberculosis. T-cell-based interferon gamma release assay (IGRA) is another non-invasive test that could be used as a substitute for tuberculin skin test [18] [2] . In 1 study, IGRA was found to have sensitivity between 72-90% and specificity between 68%-82% [18] .…”

Section: Discussionmentioning

confidence: 99%

“…T-cell-based interferon gamma release assay (IGRA) is another non-invasive test that could be used as a substitute for tuberculin skin test [18] [2] . In 1 study, IGRA was found to have sensitivity between 72-90% and specificity between 68%-82% [18] . While having lower sensitivity and specificity than ADA, IGRA is sometimes used first as it doesn't require an invasive procedure to obtain ascitic fluid.…”

Section: Discussionmentioning

confidence: 99%

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Asymptomatic peritoneal tuberculosis in a patient with a non-remitting fever and isolated pulmonary symptoms: a case report and literature review

Ahmadi

Tapper

Al-Obudi

et al. 2021

Radiology Case Reports

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Tuberculosis (TB) remains one of the leading causes of death globally. Although abdominal or peritoneal TB is a recognised site for extrapulmonary TB to manifest, the diagnosis is often delayed due to the non-specific nature of the presenting clinical features. We present the diagnostically challenging case of a 32-year-old patient with recurrent episodes of fever and a non-productive cough that was initially treated as community-acquired pneumonia with oral antibiotics. A computed tomography scan of the thorax was unrevealing, aside from a large volume of ascites within the partially imaged upper abdomen. The patient did not report any abdominal symptoms and the abdominal examination was unremarkable. Subsequently, a transvaginal ultrasound, a contrast-enhanced computed tomography scan of the abdomen and pelvis, and magnetic resonance imaging of the abdomen and pelvis confirmed a large volume of ascites in the absence of any definite aetiology. A peritoneal biopsy was required before the diagnosis of peritoneal TB was eventually confirmed. This case highlights the importance of considering peritoneal TB in patients presenting with treatment-resistant chest symptoms and persistent pyrexia of undetermined aetiology, even in the absence of abdominal signs and symptoms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Asymptomatic peritoneal tuberculosis in a patient with a non-remitting fever and isolated pulmonary symptoms: a case report and literature review

Ahmadi

Tapper

Al-Obudi

et al. 2021

Radiology Case Reports

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“…Currently, there is no available classification to determine the degree of abdominal tuberculosis extension that resembles ovarian mass. Therefore, we tried to arrange a scoring system based on previous studies regarding abdominal TB characteristics [6,[10][11][12][13]. The lowest score was 4, which was included in mild degree category, and the highest score was 13, which was included in severe degree category.…”

Section: Discussionmentioning

confidence: 99%

“…The degree of abdominal TB extent from abdominal CT-scan findings with contrast was classified based on previous studies and had been published and used the following scoring system: • Mild, if the score is between 5-8 • Moderate, if the score is between 9-12 • Severe, if the score is more than 12 [6,[10][11][12][13]].…”

Section: Data Collectionmentioning

confidence: 99%

Abdominal Tuberculosis Mimicking Ovarian Cancer on Ct Scan: The Value of Chest X-Ray in Diagnosis

Tripriyanggara¹,

Mardiyana²,

Onk.Rad³

et al. 2021

IJRP

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Background: Difficulties in diagnosing abdominal tuberculosis prevent the patient from receiving optimal therapy. The objective of this study was to determine whether chest X-rays have value in the diagnosis of abdominal tuberculosis which mimics ovarian cancer on CT-scans. Materials and Methods: : This was a retrospective study on abdominal tuberculosis patients who had mimicked ovarian cancer on CT-scans at Soetomo Hospital Surabaya from January 2015 to December 2020. Results: We included 33 patients in this study. The diagnosis was confirmed by biopsy and histopathological examination. The patient age ranged between 20 and 60 years. Twenty patients (60.6%) had normal chest X-rays. The most common severity level of CT scans results of abdominal tuberculosis was moderate severity (63.67%), which was most common in both the group of normal chest X-rays (65%) and the group of chest X-rays with pulmonary tuberculosis (61.5%). Pearson chi-square test showed there was no statistical relationship between the presence of pulmonary tuberculosis on chest X-ray and the extent of abdominal tuberculosis on CT scan. The contingency coefficient between the variables obtained an r of 0.157 (p> 0.05). Conclusion: Chest X-ray is considered to have no significant role in the diagnosis of abdominal tuberculosis mimicking ovarian cancer on CT-scan.

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“…It allows not only inspection of peritoneum, but also obtaining specimens for histology with lower risk of surgical morbidity. 15,24 Positive appearance of TB in 96% of cases 6 . This includes scattered or confl uent multiple, whitish, miliary nodules (<5 mm) over the visceral and parietal peritoneum, adhesion, thickened and hyperemic peritoneum, and turbid ascites.…”

Section: Discussionmentioning

confidence: 99%

Role of Ambulatory Laparoscopy in Diagnosis of Ascites with Unknown Etiology

Situmorang

Surya²,

Hellyanti

2021

Indones J Obstet Gynecol

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Background: Ascites could be caused by many underlying diseases, mainly portal hypertension, malignancy, and heart failure. Other etiologies include tuberculosis and pancreatitis. Difficulties in confirming the cause of ascites have been seen in many clinical settings. Ambulatory laparoscopy is one of powerful tools to rule out many etiologies of ascites despite being invasive in its nature. This case report would like to show one case of peritoneal TB presenting with ascites. Patient has undergone many laboratory workups in search of ascites origin. Literature study is done to look for evidence about timing and role of laparoscopy in ascites work-up. Case illustration: A-26-year-old P2 woman came to hospital with a history of vaginal delivery 22 days before admission presenting with massive ascites. No obstetric complication was found. Transvaginal ultrasound revealed normal postpartum uterus and ovaries, surrounded with ascites. Both the liver and kidneys were found normal on ultrasound. Abdominal CT scan with contrast showed massive ascites with thickened omentum. ADA was 36 IU/L. We decided to perform diagnostic laparoscopy and biopsy for histopathology. We found massive yellowish ascites and hyperaemic tubal enlargement with thickening of the peritoneum. Pathology examination proved the appearance of chronic salpingitis and granulomatous peritonitis consistent with tuberculosis peritonitis. Conclusion: Laparoscopy as a minimal invasive tool can diagnose ascites with unknown etiology patients after failure to prove diagnosis from clinical laboratory and radiological examination. It is one best alternative to diagnose peritoneal TB presenting with ascites with its superiority in visualizing abdominal cavity and obtaining specimens for histology with lower risk of morbidity.

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A diagnostic approach for differentiating abdominal tuberculosis from ovarian malignancy: a case series and literature review

Cited by 11 publications

References 36 publications

Asymptomatic peritoneal tuberculosis in a patient with a non-remitting fever and isolated pulmonary symptoms: a case report and literature review

Asymptomatic peritoneal tuberculosis in a patient with a non-remitting fever and isolated pulmonary symptoms: a case report and literature review

Abdominal Tuberculosis Mimicking Ovarian Cancer on Ct Scan: The Value of Chest X-Ray in Diagnosis

Role of Ambulatory Laparoscopy in Diagnosis of Ascites with Unknown Etiology

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