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Esophageal tuberculosis: an unusual cause of dysphagia

2009; Elsevier BV; Volume: 69; Issue: 6 Linguagem: Inglês

10.1016/j.gie.2008.06.016

1097-6779

Paula C. Peixoto, Paula Ministro, A. Sadio, Eugénia Cancela, Ricardo Araújo, Joana Machado, António Castanheira, Américo T. Silva, Rui D. Nunes, Maria Teresa Feital de Carvalho, António F. Caldas,

Infectious Diseases and Tuberculosis

The esophagus's involvement in tuberculosis is rare, and the clinical presentation may mimic an esophageal carcinoma. A 70-year-old man who is immunocompetent and with dysphagia and weight loss over the previous 3 months was referred to our department with imaging findings of an esophageal cancer. Esophagoscopy showed 2 shallow, longitudinal ulcers with irregular edges in the mid esophagus. Bronchofibroscopy revealed an ulcer of shaded borders and a whitish center in the right bronchus. Histologic samples showed epithelioid cell granuloma, caseous necrosis, and Langhans-type multinucleated giant cells. Direct and culture examinations were negative. Mycobacterial DNA was detected by a polymerase chain reaction (PCR) assay of gastric aspirate. The patient was treated with tuberculostatics, with the result that his complaints resolved, and there was complete mucosa healing.