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Case Reports in Medicine
Volume 2012, Article ID 646525, 4 pages
http://dx.doi.org/10.1155/2012/646525
Case Report

Endoscopic Aspects of Gastric Syphilis

Gastrointestinal Endoscopy Unit of the Hospital of Clinics of the University of São Paulo Medical School, Avenue Dr. Enéas de Carvalho Aguiar, 255 6° Andar do Prédio dos Ambulatórios, Cerqueira César, CEP 05403-000, São Paulo, SP, Brazil

Received 28 April 2012; Accepted 15 July 2012

Academic Editor: Abhay R. Satoskar

Copyright © 2012 Mariana Souza Varella Frazão et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Considered as a rare event, gastric syphilis (GS) is reported as an organic form of involvement. Low incidence of GS emphasizes the importance of histopathological analysis. Objective. We aim to characterize GS endoscopic aspects in an immunocompetent patient. Case Report. A 23-year-old man presented with epigastric pain associated with nausea, anorexia, generalized malaise and 11 kg weight loss that started 1 month prior to his clinical consultation. Physical examination was normal except for mild abdominal tenderness in epigastrium. Endoscopy observed diminished gastric expandability and diffuse mucosal lesions, from cardia to pylorus. Gastric mucosa was thickened, friable, with nodular aspect, and associated with ulcers lesions. Gastric biopsies were performed, and histopathological analysis resulted in dense inflammatory infiltration rich in plasmocytes. Syphilis serologies were positive for VDRL and Treponema pallidum reagents. Immunohistochemical tests were positive for Treponema pallidum and CD138. The patient was treated with penicillin, leading to resolution of his clinical complaints and endoscopic findings. Conclusion. Diagnosis suspicion of GS is important in view of its nonspecific presentation. Patients with gastric symptoms that mimic neoplastic disease should be investigated thoroughly based on the fact that clinical, endoscopic, and histological findings can easily be mistaken for lymphoma or plastic linitis.