de Silva R, Stoopack P M, Raufman J P
Department of Radiology, State University of New York Health Science Center, Brooklyn.
Radiology. 1990 May;175(2):449-53. doi: 10.1148/radiology.175.2.2326472.
Although opportunistic infections of the esophagus occur commonly in acquired immunodeficiency syndrome (AIDS), inflammation is generally limited to the mucosal surface. During a 7-month interval, six men at risk for AIDS underwent barium esophagography because of persistent symptoms of esophageal disease. In each case, transmural inflammation of the esophagus was found (esophagomediastinal communication in three cases and esophagobronchial fistulas in three cases). Two patients had an esophagoesophageal fistula, an inflammatory lesion that has not, to the authors' knowledge, been previously described with mycobacterial infection. Mycobacterial infection was documented by means of culture findings in all six patients (Mycobacterium tuberculosis in five, M avium in one). In three cases mycobacteria were either seen in or cultured from esophageal biopsy specimens. The finding of deep esophageal ulceration, intramural dissection, or fistula formation in a patient with AIDS should suggest the diagnosis of esophageal tuberculosis.
尽管食管机会性感染在获得性免疫缺陷综合征（AIDS）中很常见，但炎症通常局限于黏膜表面。在7个月的时间里，6名有患AIDS风险的男性因食管疾病的持续症状接受了食管钡餐造影检查。在每例病例中，均发现食管透壁性炎症（3例为食管纵隔瘘，3例为食管支气管瘘）。2例患者有食管食管瘘，据作者所知，这种炎症性病变以前尚未在分枝杆菌感染中描述过。所有6例患者均通过培养结果证实有分枝杆菌感染（5例为结核分枝杆菌，1例为鸟分枝杆菌）。3例病例中，在食管活检标本中可见分枝杆菌或培养出分枝杆菌。AIDS患者出现深部食管溃疡、壁内剥离或瘘管形成应提示食管结核的诊断。
