Esophageal tuberculosis: definitive diagnosis by endoscopy.

This report describes a patient with a 2-wk history of epigastric pain and dysphagia, and a mid-esophageal ulceration resulting from infection with Mycobacterium tuberculosis. This is an uncommon site of tuberculous involvement, and usually results from direct extension from adjacent mediastinal or hilar lymph nodes, reactivated lung infection, infected vertebral bodies or aortic aneurysms, or from extension from the pharynx or larynx. The endoscopic lesion is ulcerative, with shallow, smooth edges, granular, with small mucosal miliary granulomas, or hyperplastic, with fibrosis, luminal narrowing, and stricture formation. The patient responded well to antituberculous therapy, and is healthy 4 yr after therapy.