[A case of esophageal tuberculosis which developed during the treatment for tuberculous lymphadenitis].
A 23-year-old man was admitted to the other hospital complaining of fever and lymph node swelling in the left neck. Computed tomography showed swollen mediastinal lymph nodes without intrapulmonary lesions. Mycobacterium tuberculosis were identified by sputum culture and cervical lymph node biopsy and the case was diagnosed as tuberculous lymphadenitis. Three weeks after starting treatment with four anti-tuberculous drugs, he complained chest pain while eating and chest X-ray showed a new infiltrative shadow in the right cardiophrenic angle, then he was admitted to our hospital. Esophagoscopy revealed a deep ulceration with fistulas at 30 cm from the incisor and he was diagnosed as esophageal tuberculosis by histological examination of the biopsy specimen showing remarkable leukocytes infiltration and epithelioid cell granulomas with a few multinucleated giant cells. After antituberculous chemotherapy for six months, the mediastinal and cervical lymphadenopathy were reduced in size and the esophageal ulceration almost disappeared. Although esophageal tuberculosis is rare, the disease might develop during or after mediastinal or periesophageal tuberculous lymphadenitis.
Hashimoto
Tomohiro
T
Department of Respiratory Medicine, National Hospital Organization Chiba-East National Hospital, 673 Nitona-cho, Chuo-ku, Chiba-shi, Chiba 260-8712 Japan. hashimo@nitona.hosp.go.jp
Sasaki
Yuka
Y
Yagi
Takenori
T
Itakura
Meishi
M
Sugiyama
Rei
R
Yamanaka
Mikako
M
Tsuyuzaki
Junichi
J
Yamagishi
Fumio
F
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004935:Esophageal Diseases / Q000175:diagnosis / Q000209:etiology*; D004945:Esophagoscopy; D006801:Humans; D008297:Male; D014376:Tuberculosis / Q000175:diagnosis / Q000209:etiology*; D014388:Tuberculosis, Lymph Node / Q000150:complications* / Q000188:drug therapy
D000995:Antitubercular Agents