摘要
BACKGROUND Tuberculosis(TB)has a rare extrapulmonary manifestation known as esophageal tuberculosis,accounting for 0.2%of total TB patients.Esophageal TB typically presents with dysphagia,with retrosternal pain or odynophagia,but generalized symptoms such as low-grade fever,decreased appetite,and weight loss are also observed.Esophageal carcinoma and Crohn’s disease of the esophagus are important differential diagnoses with similar presentation.CASE SUMMARY We present a case of a 25-year-old male,who presented with esophageal TB mimicking an esophageal carcinoma.Lab work-up,Mantoux test,and chest X-ray were normal.Barium-swallow examination showed moderate dilatation of distal esophagus with a nodular and irregular mucosa.Computed tomography showed significant thickening of thoracic and distal esophagus with infiltration into the lesser omentum and large,centrally necrotic lymph nodes on gastro-hepatic ligament suggestive of a possible malignancy.Esophagoscopy was performed and a biopsy of mural thickening was performed and sent for histopathological examination.The histopathology report and TB-polymerase chain reaction confirmed the diagnosis of esophageal TB.The patient was started on antituberculous therapy(ATT),and complete resolution of symptoms and disease was achieved in 6 mo.CONCLUSION Esophageal TB is an extremely rare,yet important differential diagnosis in a patient presenting with dysphagia.Esophageal TB can mimic esophageal carcinoma on computed tomography scan.The patient responded well to a complete course of ATT.
BACKGROUND Tuberculosis(TB) has a rare extrapulmonary manifestation known as esophageal tuberculosis, accounting for 0.2% of total TB patients. Esophageal TB typically presents with dysphagia, with retrosternal pain or odynophagia, but generalized symptoms such as low-grade fever, decreased appetite, and weight loss are also observed. Esophageal carcinoma and Crohn’s disease of the esophagus are important differential diagnoses with similar presentation.CASE SUMMARY We present a case of a 25-year-old male, who presented with esophageal TB mimicking an esophageal carcinoma. Lab work-up, Mantoux test, and chest X-ray were normal. Barium-swallow examination showed moderate dilatation of distal esophagus with a nodular and irregular mucosa. Computed tomography showed significant thickening of thoracic and distal esophagus with infiltration into the lesser omentum and large, centrally necrotic lymph nodes on gastro-hepatic ligament suggestive of a possible malignancy. Esophagoscopy was performed and a biopsy of mural thickening was performed and sent for histopathological examination. The histopathology report and TB-polymerase chain reaction confirmed the diagnosis of esophageal TB. The patient was started on antituberculous therapy(ATT), and complete resolution of symptoms and disease was achieved in 6 mo.CONCLUSION Esophageal TB is an extremely rare, yet important differential diagnosis in a patient presenting with dysphagia. Esophageal TB can mimic esophageal carcinoma on computed tomography scan. The patient responded well to a complete course of ATT.
