Supplementary Material for: Tuberculosis of The Stomach Mimicking Gastric Submucosal Tumor: Diagnosis by Endoscopic Ultrasound

Introduction: Gastrointestinal tuberculosis (TB), specifically gastric TB, is a rare form of extrapulmonary TB. Diagnosis proves challenging with non-specific signs and symptoms. In this case report, a 22-year-old male came in with complaints of recurrent hematemesis and melena.

Case presentation: We found a submucosal mass with ulceration in the stomach cardia on esophagoduodenoscopy (EGD). The endoscopic ultrasound (EUS) finding was a hypoechoic submucosal lesion with a clear margin; specimens were taken using fine needle aspiration (FNA) for further histopathological examination. The result indicated granuloma of Mycobacterium Tuberculosis in pathology, suggesting that the diagnosis was gastric TB. The patient was then treated with antitubercular therapy regimen for nine months. The previously documented mass in the stomach cardia was no longer visible on the follow-up endoscopy examination, and the patient was considered cured.

Conclusion: This case shows that gastric tuberculosis should be considered in patients with gastrointestinal symptoms, especially those living in TB endemic regions. Endoscopic examinations, such as EGD and EUS, may aid in the diagnosis of gastric tuberculosis.

引言：胃肠道结核（Gastrointestinal tuberculosis, TB）中，胃结核属于罕见的肺外结核亚型，因临床表现缺乏特异性，诊断颇具挑战。本病例报告纳入1名因反复呕血与黑便就诊的22岁男性患者。

病例介绍：食管十二指肠镜（esophagoduodenoscopy, EGD）检查显示，患者胃贲门处存在伴溃疡的黏膜下肿物。内镜超声（endoscopic ultrasound, EUS）提示为边界清晰的低回声黏膜下病变，遂通过细针抽吸活检（fine needle aspiration, FNA）采集标本行组织病理学检查。病理结果提示存在结核分枝杆菌（Mycobacterium Tuberculosis）肉芽肿，据此确诊为胃结核。患者随后接受了为期9个月的抗结核治疗。随访内镜检查显示，此前检出的胃贲门肿物已完全消失，患者临床治愈。

结论：本病例表明，对于存在胃肠道症状的患者，尤其是来自结核流行地区的人群，需将胃结核纳入鉴别诊断范畴。食管十二指肠镜、内镜超声等内镜检查手段可辅助胃结核的临床诊断。