Gupta S P, Arora A, Bhargava D K
Department of Medicine, All India Institute of Medical Sciences, New Delhi.
Tuber Lung Dis. 1992 Jun;73(3):174-6. doi: 10.1016/0962-8479(92)90153-b.
Oesophageal tuberculosis secondary to tuberculous mediastinal lymphadenopathy is a very unusual presentation of adult tuberculosis. We report a young patient who presented with anorexia and weight loss. The chest radiograph and CT scan revealed mediastinal lymphadenopathy causing extrinsic oesophageal compression on the barium swallow. This was confirmed by upper gastrointestinal endoscopy. Four weeks later, because of spontaneous partial relief in dysphagia, upper gastrointestinal endoscopy was repeated and revealed an ulcerated lesion with nodular margins at the mid-oesophagus. Biopsy from the ulcer margin revealed non-caseating granulomas. The patient had complete relief of dysphagia and other symptoms within 3 weeks of start of antituberculosis therapy.
继发于结核性纵隔淋巴结肿大的食管结核是成人结核病一种非常罕见的表现形式。我们报告一名出现厌食和体重减轻的年轻患者。胸部X光片和CT扫描显示纵隔淋巴结肿大，在吞钡检查时导致食管外部受压。上消化道内镜检查证实了这一点。四周后，由于吞咽困难自发部分缓解，再次进行上消化道内镜检查，发现食管中段有一个边缘呈结节状的溃疡病变。溃疡边缘活检显示为非干酪样肉芽肿。患者在开始抗结核治疗3周内吞咽困难和其他症状完全缓解。
