We report the case of a 68-year-old man, with no history of interest and asymptomatic from the digestive point of view.
The patient was admitted to the emergency department with a positive fecal occult blood test (FOBT).
The rest of the blood tests, as well as the physical examination, showed no findings of interest.
An ileocecal valve was created in which an ulcerated lesion was observed at the cecum level, facing the ileocecal valve, compatible with malignant neoplasia, from which multiple biopsies were taken.
These showed ulcerated tissue without appreciating tumor cells.
The diagnostic suspicion was completed by CT, which showed thickening of the cecum wall and ascending colon with no data of lymph node or distant involvement.
Tumor markers were normal.
Given the negativity found in the samples, it was decided to repeat the diagnosis, taking again biopsies, which were also negative for malignancy.
Biopsies taken from the first stage were reviewed, showing granulomas with presence of multinucleated giant cells and mycobacterial bacilli with Ziehl Nielsen stain.
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The patient was admitted to the outpatient Pneumology service, but did not present respiratory symptoms.
The Mantoux test was negative, but Quantiferon® was positive (value: 5.12).
Chest X-ray showed a nodular infiltrate in both upper lung fields.
Sputum samples were collected, which were not bacilliferous, and samples were sent for culture, which were negative.
PCR of colon samples was also negative.
Standard anti-tuberculous treatment was established with good clinical outcome.
Six months after the end of the treatment, a control loop was performed which was normal.
