Unusual presentation of esophageal tuberculosis mimicking malignancy

Patnayak, Rashmi; Reddy, Munish; Parthasarathy, Sriram; Yootla, Mutheeswaraiah; Reddy, Venkatarami; Jena, Amitabh

doi:10.4103/1319-3767.39632

Cited by 9 publications

(6 citation statements)

References 2 publications

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“…We did not find other lesions like hyperplastic and granular lesions. 5,8,14 though the ulcers are nonspecific but if they are present in middle one third of esophagus, and are have slightly infiltrated edges, irregular outline, grayish base with or without extrinsic compression in predisposed individuals or in tropical countries esophageal tuberculosis should be considered.…”

Section: Discussionmentioning

confidence: 99%

Esophageal tuberculosis: role of endoscopic ultrasound in diagnosis

Puri¹,

Khaliq

Kumar

et al. 2011

Diseases of the Esophagus

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Esophageal involvement by tuberculosis is rare and is commonly secondary to mediastinal lymph nodal involvement. Endoscopic ultrasound (EUS) is a good modality for evaluation of both esophageal wall and mediastinal lymph nodes. The objectives were to study the role of EUS in diagnosing esophageal tuberculosis, to differentiate primary from secondary form, and to assess the response. Retrospective analysis of data over 7 years (i.e. from 2003 to 2009) was used. The study was set in a tertiary care referral institute and focused on patients diagnosed with esophageal tuberculosis. Interventions used included endoscopy, EUS, EUS-FNA (fine needle aspiration) followed by antituberculosis treatment. The main outcome measurements were symptoms, endoscopic features, EUS features, pathological yield, and response to treatment. There were 32 cases of esophageal tuberculosis. The primary symptom was dysphagia, and endoscopy showed ulcers in 18/32 (56.25%) and extrinsic bulge in 20/32 (62.5%) in middle one third of esophagus. EUS showed lymph nodes adjacent to esophageal pathology in all cases. Subcarinal region was the most common site of lymphadenopathy and they were matted, heterogeneous with predominantly hypoechoic center. Histopathology of endoscopic biopsy of ulcers and EUS-FNA of lymph nodes provided the diagnosis of tuberculosis in 27/32 (84.35%). All patients were treated with antitubercular treatment and showed good clinical, endoscopic and endosonographic response. This is a retrospective study, and PCR and culture for Mycobacterium tuberculosis were not done. Esophageal tuberculosis does not appear to be a primary disease and is most likely secondary to mediastinal nodal tuberculosis. A conglomerated mass of heterogeneous with predominantly hypoechoic lymph nodes with intervening hyperechoic strands and foci on EUS appears to be characteristic of mediastinal tuberculosis.

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Section: Discussionmentioning

confidence: 99%

Esophageal tuberculosis: role of endoscopic ultrasound in diagnosis

Puri¹,

Khaliq

Kumar

et al. 2011

Diseases of the Esophagus

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“…La endoscopía puede ser útil para el diagnóstico y el seguimiento de la enfermedad. La lesión más común es una úlcera tuberculosa, con una base grisácea y un borde infiltrado irregularmente; además, la TE puede presentarse como una lesión proliferativa estenosante, y puede confundirse fácilmente con una neoplasia (14,15) . Aunque varios autores reportan lesiones submucosas con más frecuencia, por lo general, predominan las lesiones ulceradas.…”

Section: Discussionunclassified

Tuberculosis primaria de esófago: reporte de caso

Humpire

Lazo²,

Bejarano

et al. 2020

Horizmed

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Mujer de 60 años, natural de Tarma y procedente de Lima, con antecedentes de exposición a biomasas, contacto con paciente con tuberculosis, hipertensión arterial, arritmia cardiaca, y madre con cáncer de ovario. La paciente acude a consulta con un cuadro de siete meses de evolución caracterizado por disfagia progresiva, pérdida de peso de 15 kilogramos y fiebre vespertina. En la endoscopía previa mostró un tumor esofágico, y la tomografía reveló un engrosamiento tumoral a nivel de los tercios medio y distal del esófago, dependiente de la pared, y adenopatías mediastinales de 10x10 mm. Los demás órganos torácicos y abdominales no muestran alteraciones. En la última endoscopía se encuentra una lesión ulcerada en esófago y en el estudio patológico se observó una extensa inflamación crónica granulomatosa con células gigantes y necrosis; la prueba de Ziehl Neelsen para el bacilo de Koch (BK) fue negativa sin evidencia de lesión maligna y la reacción en cadena de la polimerasa (PCR) fue positiva para Mycobacterium. Se tomó una biopsia de las adenopatías mediante una ecoendoscopía, con una PCR negativa para Mycobacterium. Concluimos que el cuadro fue una tuberculosis esofágica primaria, y se inició el tratamiento con el esquema específico sensible a una dosis ajustada por peso.

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“…Several mechanisms seem to be involved in this form of infection, such as direct extension of pharyngeal tuberculosis, dissemination of a distant site and inoculation of bacilli. 5,6 In this context, it is important to present and discuss the clinical manifestations of extrapulmonary forms of tuberculosis, as well as its repercussions on the nutritional status of the patients affected.…”

Section: Introductionmentioning

confidence: 99%

A nutritional approach to esophageal tuberculosis - case report

Brasiel¹,

Dutra²

2018

GHOA

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Esophageal tuberculosis is a rare event, but when present, it presents an important repercussion on the nutritional status of the affected individuals. We report a case of a 47-year-old woman with a history of progressive dysphagia and associated weight loss, diagnosed with esophageal tuberculosis, possibly infected by food inoculation of the bacilli. Being the nutritional monitoring essential for the good outcome of the case.

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Unusual presentation of esophageal tuberculosis mimicking malignancy

Cited by 9 publications

References 2 publications

Esophageal tuberculosis: role of endoscopic ultrasound in diagnosis

Esophageal tuberculosis: role of endoscopic ultrasound in diagnosis

Tuberculosis primaria de esófago: reporte de caso

A nutritional approach to esophageal tuberculosis - case report

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