GRANÜLOMATÖZ GASTRİT/ OLGU SUNUMU

Granülomatöz gastrit nadir görülen bir kliniko-patolojik antitedir. Etiyolojik faktörler çok çeşit-lidir. Crohn hastalığı granülomatöz gastiritin en sık sebebidir. Gastrik tüberküloz, abdominal tü-berkülozun nadir bir formudur. Ancak endemik bölgelerde gastrik tüberküloz granülomatöz gastiritin ayırıcı tanısında akla gelmelidir. Kesin tanı morfolojik bulgular, klinik ve laboratuvar bulguları değerlendirilerek konur. Ancak bütün bu multidisipliner yaklaşıma rağmen kesin tanı verilemeyebilir. 38 yaşında kadın hastada gra-nülomatöz gastrit olgusunu sunduk. Histomor-folojik görünümü ve klinik bulguları ile primer tüberküloz gastrit yönünden şüpheli olarak de-ğerlendirilen olgu antituberküloz tedavi sonrası düzelmiştir. Biz bu olguyu nadir bir antite ola-rak sunmayı, bu olgu ile birlikte granülomatöz gastrit etiyolojisi ve histomorfolojisini gözden geçirmeyi uygun gördük.

GRANULOMATOUS GASTRITIS/ CASE REPORT

Granulomatous gastritis is an uncommon clini-copathologic entity. Etiologic factors are extre-mely various. Crohn’s disease is the most com-mon cause of granulomatous gastritis. Gastric tuberculosis is a rare form of abdominal tuber-culosis. However, gastric tuberculosis should be considered in the differential diagnosis of granulomatous gastritis in endemic areas. Final diagnosis is reached by the evaluation of clinic, morphologic and laboratory findings. Howe-ver, despite all this multidisciplinary approach definite diagnosis may not given. We present the cases of granulomatous gastritis in 38 year old female. Histomorphological appearance and clinical findings of patient considered as primary tuberculosis gastritis and patient’s cli-nical and endoscopic finding improved after antituberculosis treatment. We considered this case as an uncommon entity and also found it suitable to review granulomatous gastritis etio-logy and histomorphology with the presentati-on of the case.

Kaynakça

14. Singh B, Moodley J, Ramdial P, Haffejee AA, Royeppen E, Maharaj J. Primary gastric tuberculosis. A report of 3 cases. S Afr J Surg. 1996 Feb; 34(1): 29-32.

13. Kamani L, Mumtaz K, Azad NS, Jafri W, Granulomatous gastritis: a diagnostic dilemma? Singapore Med J 2008; 49(9): e 222-4

12. Lopez Caleya JF, Martin Rodeigo L, Mohammed Mourad F, De la Iglesia Fanjul, Martin Sanchez V, Gastric tuberculosis. Rewiew apropos of a case, Gastroenterol hepatol, 2007, Jun-July; 30(6): 334-7

11. Taş A, Karaman G, Çelik H. An unusual cause of granulomatous gastritis in an elderly patient: Helicobacter pylori. Turk J Gastroenterol. 2013; 24 (4): 368-9.

10. Yamane T, Uchiyama K, Ishii T, Nakano M, Kanetsuna Y, Okusa T, Tajiri H. Isolated granulomatous gastritis showing discoloration of lesions after Helicobacter Pylori eradication. Dig Endosc. 2010 Apr; 22(2): 140-3. doi: 10.1111/j.1443-1661.2010.00938.x.

9. Bigotti G, Coli A, Magistrelli P, et al. Gastric adeno carcinoma associated with granulomatous gastritis. Case report and review of the literatüre, Tumori 2002 Mar-Apr; 88(2): 163-6

8. Groisman GM, Rosh JR, Harpaz N. Langerhans cell histiocytosis of the stomach. A cause of granulomatous gastritis and gastric polyposis. Arch Pathol Lab Med. 1994 Dec; 118(12): 1232-5.

7. Temmesfeld-Wollbrueck B, Heinrichs C, Szalay A, Seeger W. Granulomatous gastritis in Wegener’s disease: differentiation from Crohn’s disease supported by a positive test for anti neutrophil antibodies. Gut. 1997 Apr; 40(4):550-3.

6. Palmer ED. Note of silent sarcoidosis of the gastric mucosa. J. Lab. Clin. Med. 1958; 52(2): 231-4

5. Niitsu H, Tanabe K, Tokumoto N, Suzuki T, Tanaka A, Arihiro K, Ohdan H. Idiopathic granulomatous gastritis resembling a gastrointestinal stromal tumor. Case Rep Gastroenterol. 2012 May; 6(2): 502-9

4. Hirsch BZ, Whitington PF, Kirschner BS, Black DD, Bostwick DG, Yousefzadeh DK. Isolated granulomatous gastritis in an adolescent. Dig Dis Sci. 1989 Feb; 34(2): 292-6.

3. Giacobbe A, Facciorusso D, Cattani L, Tonti P, Andriulli A, Bisceglia M. Does single granuloma warrant a diagnosis of idiopathic granulomatous gastritis?J Clin Gastroenterol. 1993 Apr; 16(3): 261-3.

2. Aga R, McCarthy JH. Persistent granulomatous gastritis. Br J Clin Pract. 1990 Oct; 44(10): 414-5.

1. Ectors NL, Dixon MF, Geboes KJ, Rutgeerts PJ, Desmet VJ, Vantrappen R. Granulomatous gastritis: a morphological and diagnostic approach. Histopathology 1993; 23(1): 55-61

Kaynak Göster