An Unusual Finding of Schaumann Bodies in the Intestine in Abdominal Tuberculosis: A Rare Case Report

Introduction: Granulomatous appendicitis is rare, with infectious etiologies such as tuberculosis being significant especially in endemic regions. Schaumann bodies are classically associated with sarcoidosis and occasionally Crohn's disease but rarely reported in gastrointestinal tuberculosis. The coexistence of tuberculous granulomatous appendicitis and Schaumann bodies without granulomas in the intestine is exceptionally unusual. Case Report: A young male in his late thirties presented with acute appendicitis and incidental proximal ileal thickening. Histopathology of the appendix revealed non-caseating epithelioid granulomas and positive Ziehl-Neelsen staining, confirming tuberculosis. The patient commenced anti-tubercular therapy. Approximately 100 days later, he developed ileal stricture with perforation requiring resection and ileostomy. Histology of the ileal segment demonstrated distinctive Schaumann bodies within muscularis propria giant cells. However granulomas were not noted in the intestine. Typical histologic features of Crohn's disease as well as systemic features of sarcoidosis were absent.Discussion: This case highlights a rare presentation of tuberculous granulomatous appendicitis with concomitant Schaumann bodies in the small intestine, expanding the pathological spectrum of abdominal tuberculosis. Recognition of such histological findings is essential for accurate diagnosis and management in tuberculosis-endemic areas.