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Tuberculosis of the esophagus
J A Perdomo1, Y Naomoto, M Haisa
1First Department of Surgery, Okayama University Medical School, Japan.
Summary
Esophageal tuberculosis is a rare condition. This case highlights its diagnosis through endoscopic and histological findings, leading to successful treatment with antitubercular drugs.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pulmonology
Background:
- Esophageal tuberculosis is an exceptionally 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, suggesting an unusual esophageal pathology.
Findings:
- Bacterial examination of esophageal ulcer smears confirmed Mycobacterium tuberculosis.
- Histological analysis of cervical lymph nodes showed caseating granulomas, indicative of tuberculosis.
- Tuberculous mediastinal lymphadenitis was identified as the likely source of esophageal involvement.
Implications:
- This case underscores the importance of considering esophageal tuberculosis in the differential diagnosis of unexplained esophageal lesions, even in patients without typical risk factors.
- Early and accurate diagnosis, supported by microbiological and histological evidence, is crucial for effective management.
- Successful treatment with a standard three-drug antitubercular regimen confirms the efficacy of conventional therapy for this rare presentation.