Esophageal tuberculosis in an HIV-positive patient mimicking a spindle cell tumor (original) (raw)

Esophageal tuberculosis: an unusual cause of dysphagia

Gastrointestinal Endoscopy, 2009

A 25-year old Indian exchange-student presented to our department with a three week history of dysphagia. Diagnostic evaluation by upper gastrointestinal endoscopy, endosonography and chest-CT revealed a tumor-suspect ulcerative lesion at the middle esophagus, and a mediastinal lymph node enlargement. Initial histopathological evaluation of multiple esophageal tissue biopsies showed an unspecific esophagitis without signs for malignancy. A positive T-spot ® . TB assay result, together with the bronchoscopic detection of a small exophytic lesion at the right main bronchus depicting caseating epitheloid cell granulomas, provided evidence for a tuberculous etiology of the esophageal tumor. Multiple further deep submucosal biopsies were needed to finally detect epitheloid cell granulomas in the esophageal lesion. Microbacteriological or molecular tests were negative for M. tuberculosis. Tuberculostatic treatment resulted in a good response with complete remission of the esophageal lesion and the mediastinal lymph node enlargement. Esophageal tuberculosis is rare in developed countries, and its possible presence deserves consideration particularly in patients at risk.

Esophageal tuberculosis: is it so rare? Report of 12 cases and review of the literature

The American Journal of Gastroenterology, 2002

OBJECTIVE: Mycobacterial involvement of the esophagus is rare in both immunocompetent and immunocompromised hosts with advanced pulmonary tuberculosis, even in countries with high prevalence rates like India. Most of the reported cases of esophageal tuberculosis (ET) are secondary to tuberculosis elsewhere in the body, most commonly pulmonary tuberculosis. Very few cases of isolated or primary ET have been reported, and most of them have been from developing countries. The upsurge in reported cases of tuberculosis linked to the AIDS epidemic has increased the incidence of this infection in developed countries also. Our aim is to study tuberculosis as an etiological factor in the causation of dysphagia, the role of cytology and histopathology in establishing its diagnosis, and the outcome of antitubercular treatment in these patients.

An Unusual Presentation of Esophageal Tuberculosis: A Case Report

Cureus, 2022

The lungs, kidneys, liver, and pancreas are just some of the organs that can be affected by tuberculosis. Tuberculosis is a disease that can affect many organs of the human body. Rarely can tuberculosis (TB) manifest itself in the digestive tract; in fact, the gastrointestinal tract ranks as the sixth most common site of extrapulmonary TB. However, involvement of the esophagus by tuberculosis is extremely uncommon. We present a case of esophageal tuberculosis in a 27-year-old man with epigastric pain and weight loss as his only symptoms. There were no complaints of odynophagia or dysphagia, nor was there any evidence of immunodeficiency. Upper gastrointestinal endoscopy found an ulcer 26 centimeters from the incisor. Histopathology and a biopsy confirmed the diagnosis of primary esophageal tuberculosis. Six months after beginning anti-TB therapy, he was confirmed to be free of tuberculosis.

A Case Report of Esophageal Tuberculosis

Revista Colombiana De Gastroenterologia, 2014

We report the case of an immune-competent man with symptoms of upper gastrointestinal bleeding secondary to esophageal ulcers of tubercular origin. Gastrointestinal involvement from Mycobacterium tuberculosis is rare even in patients with numerous occurrences of pulmonary and extrapulmonary diseases. The most frequently affected sites are the terminal ileum and the peritoneum. Esophageal tuberculosis is exotic and is usually secondary to extension from neighboring infected organs such as the mediastinal nodes and/or the bronchi. Clinical, endoscopic and radiological pictures of the esophageal disease often mimic malignancy. Tuberculosis treatment is the mainstay of treatment, and surgery is rarely required.

Primary Nasopharyngeal Tuberculosis Mimicking Carcinoma

American journal of otolaryngology and head and neck surgery, 2020

Objective: Nasopharyngeal tuberculosis is a rare condition, even in endemic tuberculosis areas. We report a case of primary nasopharyngeal tuberculosis from a non-endemic area, which presented with symptoms resembling exacerbation of previously diagnosed chronic rhinosinusitis. Case report: A 48-year-old man presented with extreme postnasal drip and an unpleasant nasal odour. Endoscopic examination revealed irregular thickening of the left lateral and posterior wall of the nasopharynx, partially covered with crusts and necrotic tissue. Histopathological study showed typical giant cell epithelioid granulomas with caseous necrosis. Direct examination after Ziehl-Neelsen staining was positive for tuberculosis. After six months of antituberculous triple therapy, endoscopic examination revealed a completely normal nasopharynx. Conclusion: To our best knowledge, this is the first published report of primary nasopharyngeal tuberculosis in a patient previously diagnosed with chronic rhinosinusitis. The difficulties in obtaining a proper diagnosis in such a case are discussed.

A case report on esophageal tuberculosis - A rare entity

International journal of surgery case reports, 2017

This is a case report of a rare form of tuberculosis in a patient presenting with dysphagia. Patient was subjected to upper gastrointestinal endoscopy, which revealed an ulcerative growth in the distal esophagus. Histopathology revealed esophageal tuberculosis. Patient was managed conservatively with Anti-Tuberculosis Treatment (ATT). Follow up endoscopy after two months revealed resolution of the growth and patient was symptomatically better. In spite of the rare nature of the disease, it can be managed effectively with ATT to avoid complications (fistula, stricture, and esophageal perforation), which might warrant surgery.

Esophageal Histoplasmosis Associated with Disseminated Tuberculosis in Acquired Immunodeficiency Syndrome

The American Journal of Tropical Medicine and Hygiene, 2009

Bacterial and fungal infections are common in acquired immunodeficiency syndrome (AIDS). Histoplasmosis is a common fungal disease in severely immunocompromised patients infected with human immunodeficiency virus (HIV) in endemic areas. In this population the most frequent form of presentation of histoplasmosis is disseminated, with the clinical manifestations being similar to those of disseminated tuberculosis. Esophageal histoplasmosis and the association of histoplasmosis with tuberculosis are infrequent. We report here a rare case of esophageal histoplasmosis associated with disseminated tuberculosis in AIDS.