Kim Joonhwan, Jang Youngwoo, Kim Kyung Oh, Kim Yoon Jae, Park Dong Kyun, Chung Dong Hae, Kim Eun Young, Chung Jun Won
Division of Gastroenterology, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
Department of Pathology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
Korean J Gastroenterol. 2016 Dec 25;68(6):312-316. doi: 10.4166/kjg.2016.68.6.312.
Isolated mediastinal tuberculous lymphadenitis is clinically rare. Its clinical presentation may mimic an esophageal submucosal tumor by extrinsic compression. A 26-year-old woman was referred to our hospital for an esophageal subepithelial tumor. A 15×10 mm sized subepithelial lesion was found 30 cm from the upper incisors on esophagogastroduodenoscopy. We diagnosed the lesion as a submucosal tumor, and performed endoscopic ultrasonography-guided fine needle aspiration for a pathologic diagnosis. The histologic examination revealed granulomatous inflammation consistent with tuberculosis. We suggest that the use of endoscopic ultrasonography and fine needle aspiration may be helpful in making an early diagnosis and planning for an optimal treatment.
孤立性纵隔结核性淋巴结炎临床罕见。其临床表现可能因外在压迫而酷似食管黏膜下肿瘤。一名26岁女性因食管上皮下肿瘤转诊至我院。在食管胃十二指肠镜检查时,于距上切牙30 cm处发现一个大小为15×10 mm的上皮下病变。我们将该病变诊断为黏膜下肿瘤,并进行了内镜超声引导下细针穿刺以明确病理诊断。组织学检查显示为符合结核的肉芽肿性炎症。我们认为,使用内镜超声和细针穿刺可能有助于早期诊断并制定最佳治疗方案。