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Tuberculosis of the esophagus
J A Perdomo1, Y Naomoto1, M Haisa1
1First Department of Surgery, Okayama University Medical School; Senou City Hospital, Okayama, Okayama and Mihara Red Cross Hospital, Mihara, Hiroshima, Japan.
Summary
Esophageal tuberculosis is rare but should be considered for uncertain esophageal lesions. Diagnosis was confirmed via bacterial examination and lymph node biopsy, with successful treatment using antitubercular drugs.
Area of Science:
- Medicine
- Infectious Diseases
- Gastroenterology
Background:
- Esophageal tuberculosis is an extremely rare manifestation of extrapulmonary tuberculosis.
- Lymphoma was initially suspected due to constitutional symptoms and mediastinal lymphadenopathy.
Observation:
- Endoscopic examination revealed ulcerative masses and a sinus tract.
- Esophagram demonstrated a sinus tract, raising suspicion for a tuberculous origin.
Findings:
- Diagnosis was confirmed by identifying Mycobacterium tuberculosis in esophageal ulcer smears.
- Histological examination of cervical lymph nodes showed caseating granulomas, indicative of tuberculosis.
Implications:
- Tuberculous mediastinal lymphadenitis was identified as the likely source of esophageal spread.
- This case highlights the importance of considering esophageal tuberculosis in differential diagnoses, even without typical risk factors.
- Successful treatment was achieved with a standard three-drug antitubercular regimen.