Marshall J B, Singh R, Demmy T L, Bickel J T, Everett E D
Department of Medicine, University of Missouri School of Medicine, Columbia 65212.
Dysphagia. 1995 Winter;10(1):53-8. doi: 10.1007/BF00261282.
Esophageal involvement with histoplasmosis is uncommon, but has been recognized in two clinical settings. Most commonly, the esophagus becomes involved as a result of contiguous mediastinal lymphadenopathy. Such patients usually present with dysphagia secondary to midesophageal compression or stricture. The esophagus can also be involved in cases of disseminated histoplasmosis. Esophageal ulcers or nodular lesions are the usual clinical manifestations in this setting. We report a case of mediastinal histoplasmosis with esophageal narrowing and mucosal ulceration that presented with dysphagia. The diagnosis was established at thoracotomy by the histologic finding of necrotizing granulomas and a positive fungal stain. The case was successfully treated with amphotericin B. The literature on esophageal and gastrointestinal histoplasmosis is reviewed.
组织胞浆菌病累及食管并不常见，但在两种临床情况下已得到确认。最常见的是，食管因相邻纵隔淋巴结病而受累。这类患者通常因食管中段受压或狭窄继发吞咽困难。在播散性组织胞浆菌病病例中食管也可受累。食管溃疡或结节性病变是这种情况下的常见临床表现。我们报告一例纵隔组织胞浆菌病伴食管狭窄和黏膜溃疡，表现为吞咽困难。通过坏死性肉芽肿的组织学发现和真菌染色阳性在开胸手术时确诊。该病例用两性霉素B成功治疗。本文对食管和胃肠道组织胞浆菌病的文献进行了综述。
