 Tuberculosis is a communicable chronic

granulomatous disease caused by

Mycobactarium tuberculosis
 It ususally involves the lungs but may affect

any organ or tissue in the body

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 ENDOCYTOSIS OF M.TB

UNCHECKED

MYCOBACTERIUM
BACILLARY
PROLIFERATION

TUBERCULOSIS

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 Kamil
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GI
A
EP NT
ITH CE
C EL LL
CA ELL OID
NE SEO
C R US
OS
IS
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 Primary
 Secondary
 Hyperplastic caecal

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 Common in india ( in ileoceacal region)
 Etiopathogenesis

◦ Ingestion of unpasturised millk

◦ Infected with M.bovis
◦ Nowadays due to pasturization of milk & control
of Tuberculosis in cattle virtually all cases of
intestinal tuberculosis are caused by
M.tuberculosis.

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 Predominant changes are in the mesentric
lymph node without any significant lesions
in the intestines
 Gross

◦ Affected lymphnodes are enlarged,matted and

caseous(tabes mesentrica)
◦ Healing by fibrosis and calcification

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• Microscopy
– Initial stage:primary
complex or Ghon’s focus
– Mesentric lymph nodes
are affected with so
typical tuberculous
granulomatous
inflammatory reaction
with caseous necrosis.
– Tuberculous peritonitis
may occur due to
spread of infection.

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 Etiopathogenosis
◦ It occurs due to swallowing of sputum in patient
with active pulmonary TB
◦ Most commonly in the terminal ileum rarely in the
colon

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• Intestinal lesions are prominent than lesion in
regional lymph nodes.
• Lesion begin in the peyer’s patches or the
lymphoid follicle with formation of small ulcer
that spread through the lymphatics to form
large ulcers which are transverse to the long
axis of the bowel.
• Ulcers coated with caseous material
• Serosa may be studded with visible tubercles.
• Advance cases transverse fibrous strictures and
intestinal obstruction are seen

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 Mucosa and submucosa show ulceration
and muscularis may be replaced by variable
degree of fibrosis.
 Tuberculous peritonitis may be observed

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 Secondary to Pulmonary TB
 Gross
 Caecum or ascending colon are thick walled

with mucosal ulceration

 Clinically lesion is palpable and may be

mistaken for carcinoma

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 Presense of caseating tubercles distinguish
condition from Crohn’s disease in which
granulomas are noncaseoating

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 Kamil
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