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A 39-year-old woman was referred to our hospital for treatment of a non-healing gastric ulcer. Esophagogastroduodenoscopy (EGD) revealed an erosion in the pyloric antrum and a longitudinal ulcer on the lesser curvature of the gastric body. The histopathologic examination of biopsy specimens revealed non-caseating epithelioid granulomas. Acid-fast staining did not reveal bacilli. The differential diagnosis included gastric tuberculosis, Crohn's disease, and sarcoidosis and empiric antituberculous therapy consisting of isoniazid, rifampicin, ethambutol, and pyrazinamide was initiated. Gastric lesions were subsequently resolved and non-caseating epithelioid granulomas were not demonstrated on the post-treatment examination. Recurrence was not observed during the follow-up period of 53 months.

Primary Gastric Tuberculosis Presenting as Non-Healing Ulcer and Mimicking Crohn's Disease