Endoscopic findings and clinical features of esophageal tuberculosis

Mycobacterial involvement of the esophagus is rare. Similar abnormal lesions of the esophagus may be confused with esophageal cancer and deep fungal infections. We studied the clinical features, endoscopic findings, the role of histopathology, and the outcome of antituberculosis treatment in patients with esophageal tuberculosis.

A single center based, retrospective study was performed. We reviewed the clinical and pathological records of patients with esophageal tuberculosis that were clinically diagnosed from 1997 to 2006.

Esophageal tuberculosis, confirmed by histology, was found in six patients. Five patients presented with local symptoms. The mean number of endoscopic sessions for a diagnosis was 1.8 sessions (range 1-3). For the histopathology, caseous necrosis was found in four patients but positive acid fast bacilli stains and tuberculosis-polymerase chain reaction were not detected. Patients diagnosed with esophageal tuberculosis tolerated medical therapy and responded well.

Because esophageal tuberculosis presents with various, diverse clinical features, and endoscopic findings, it is difficult to diagnose at one session of endoscopy. However, esophageal tuberculosis should be considered in the differential diagnosis if ulcerative lesions were found in the mid esophagus.