Park S H, Chung J P, Kim I J, Park H J, Lee K S, Chon C Y, Park I S, Kim K W, Lee D Y
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 1995 Sep;36(4):386-91. doi: 10.3349/ymj.1995.36.4.386.
Mediastinal tuberculous lymphadenitis is rare in adults, and it is even rarer for dysphagia to be the presenting symptom of mediastinal tuberculous lymphadenitis. Mediastinal tuberculous lymphadenitis with esophageal symptoms has been presented as esophageal ulceration, mucosal or submucosal mass with ulceration, fistula or sinus formation, extrinsic compression, or displacement of the esophagus. An exaggerated form of extrinsic compression may be presented as a submucosal tumor, radiologically or endoscopically. A barium esophagography of a 34 year-old woman with painful dysphagia revealed a large submucosal tumor-like mass on the mid-esophagus. The symptom was spontaneously improved over a 3-week period together with reduction of the mass size. A computed tomography of the chest disclosed an enlarged subcarinal lymph node and histologic examination of the specimen obtained by thoracoscopic biopsy brought about a diagnosis of tuberculosis. We herein report a case of mediastinal tuberculosis with unusual manifestations.
纵隔结核性淋巴结炎在成人中较为罕见，而吞咽困难作为纵隔结核性淋巴结炎的首发症状则更为罕见。伴有食管症状的纵隔结核性淋巴结炎表现为食管溃疡、伴有溃疡的黏膜或黏膜下肿块、瘘管或窦道形成、外部压迫或食管移位。一种夸张形式的外部压迫在影像学或内镜检查中可能表现为黏膜下肿瘤。一名34岁吞咽困难伴疼痛的女性进行的食管钡餐造影显示食管中段有一个大的黏膜下肿瘤样肿块。症状在3周内自行改善，肿块大小也随之缩小。胸部计算机断层扫描显示隆突下淋巴结肿大，经胸腔镜活检获取的标本组织学检查确诊为结核病。我们在此报告一例具有不寻常表现的纵隔结核病例。
