Park Jae Hyung, Kim Sung Uk, Sohn Jong Won, Chung In Kwon, Jung Min Kyu, Jeon Seong Woo, Kim Sung Kook
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kyungpook National University Hospital, Daegu, Republic of Korea.
Scand J Gastroenterol. 2010 Nov;45(11):1269-72. doi: 10.3109/00365521.2010.501524. Epub 2010 Jun 23.
Mycobacterial involvement of the esophagus is rare. Similar abnormal lesions of the esophagus may be confused with esophageal cancer and deep fungal infections. We studied the clinical features, endoscopic findings, the role of histopathology, and the outcome of antituberculosis treatment in patients with esophageal tuberculosis.
A single center based, retrospective study was performed. We reviewed the clinical and pathological records of patients with esophageal tuberculosis that were clinically diagnosed from 1997 to 2006.
Esophageal tuberculosis, confirmed by histology, was found in six patients. Five patients presented with local symptoms. The mean number of endoscopic sessions for a diagnosis was 1.8 sessions (range 1-3). For the histopathology, caseous necrosis was found in four patients but positive acid fast bacilli stains and tuberculosis-polymerase chain reaction were not detected. Patients diagnosed with esophageal tuberculosis tolerated medical therapy and responded well.
Because esophageal tuberculosis presents with various, diverse clinical features, and endoscopic findings, it is difficult to diagnose at one session of endoscopy. However, esophageal tuberculosis should be considered in the differential diagnosis if ulcerative lesions were found in the mid esophagus.
食管结核累及较为罕见。食管的类似异常病变可能会与食管癌和深部真菌感染相混淆。我们研究了食管结核患者的临床特征、内镜检查结果、组织病理学的作用以及抗结核治疗的结果。
进行了一项基于单一中心的回顾性研究。我们回顾了1997年至2006年临床诊断为食管结核患者的临床和病理记录。
经组织学证实有6例食管结核患者。5例患者有局部症状。诊断所需的内镜检查平均次数为1.8次（范围1 - 3次）。组织病理学检查中，4例患者发现干酪样坏死，但未检测到抗酸杆菌染色阳性及结核聚合酶链反应阳性。诊断为食管结核的患者耐受药物治疗且反应良好。
由于食管结核呈现出多样的临床特征和内镜检查结果，单次内镜检查难以诊断。然而，如果在食管中段发现溃疡性病变，在鉴别诊断时应考虑食管结核。
