Senior Resident, Department of Gastroenterology, TN Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India, Corresponding Author.
Assistant Professor, Department of Gastroenterology, TN Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India.
J Assoc Physicians India. 2024 Jan;72(1):104-105. doi: 10.59556/japi.71.0402.
Esophageal tuberculosis (TB) is a rare manifestation of extrapulmonary TB, accounting for <0.2% of all TB cases. Esophageal TB most commonly presents with dysphagia, odynophagia, retrosternal pain, and systemic symptoms like decreased appetite, loss of weight, and low-grade fever as associated or other presentations. We report a similar case recently encountered as an elderly male patient presented with chronic dysphagia to solids, loss of appetite, and significant loss of weight. Radiological and endoscopy pictures looked like esophageal cancer with histopathological examination (twice) negative for the same. Diagnosis of esophageal TB was confirmed by GeneXpert Ultra of biopsy sample and histopathological examination was suggestive of granulomatous esophagitis. The patient improved on 6 months antitubercular therapy. The unique aspect of this case was how the lesion mimicked an esophageal carcinoma on imaging which posed a diagnostic challenge.
食管结核（TB）是肺外结核的一种罕见表现，占所有 TB 病例的<0.2%。食管 TB 最常表现为吞咽困难、吞咽痛、胸骨后疼痛和全身症状，如食欲不振、体重减轻和低热等。我们最近遇到了一个类似的病例，一位老年男性患者表现为慢性固体食物吞咽困难、食欲不振和明显体重减轻。影像学和内镜检查结果类似于食管癌，两次组织病理学检查均为阴性。通过活检样本的 GeneXpert Ultra 检测和组织病理学检查确诊为食管 TB，检查结果提示肉芽肿性食管炎。该患者在 6 个月抗结核治疗后好转。这个病例的独特之处在于病变在影像学上如何模拟食管癌，这给诊断带来了挑战。
