A case of esophageal tuberculosis with unusual endoscopic feature

Li, Yixuan; Nian, Weidong; Wang, Huahong

doi:10.1016/j.clinre.2017.04.010

Cited by 8 publications

(4 citation statements)

References 4 publications

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“…Adicionalmente, una prueba de alto impacto actual es el uso de la endosonografía, también conocida como ecografía endoscópica, la cual tiene hallazgos característicos de esta patología; uno de estos es la presencia de ganglios linfáticos adyacentes a la patología esofágica, de localización subcarinal o periesofágica, los cuales se encontraban enmarañados (8,25), heterogéneos con una ecotextura predominantemente hipoecogénica (26) o anecoica, particularmente en el centro y algunos hilos y focos (manchas) hiperecogénicos (7,8,25). Otros hallazgos típicos son el engrosamiento de la pared esofágica y la formación de masas con disrupción de la adventicia (7,27).…”

Section: Discussionunclassified

Tuberculosis esofágica asociada con inmunosupresión por VIH: reporte de caso

Ortiz¹,

Mesa²,

Acosta³

et al. 2021

Rev colomb Gastroenterol

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Introducción: la tuberculosis es una enfermedad infecciosa que suele afectar a los pulmones y es causada por Mycobacterium tuberculosis. Se transmite de una persona a otra a través de gotículas generadas en el sistema respiratorio de pacientes con enfermedad pulmonar activa. La tuberculosis esofágica es una afección rara (representa solo el 2,8 % de todos los casos de tuberculosis gastrointestinal). Por lo general, ocurre como resultado de la diseminación directa desde los ganglios mediastínicos (rara vez desde los pulmones o el torrente sanguíneo). Su diagnóstico definitivo requiere el aislamiento de los bacilos tuberculosos, lo que rara vez se logra en la práctica clínica; aun así, clínicamente los pacientes presentan síntomas de disfagia, odinofagia y adelgazamiento. Caso clínico: se presenta un paciente de 40 años de edad con cuadro clínico de 6 meses de evolución con disfagia progresiva exacerbada a disfagia para líquidos, astenia, adinamia, hiporexia, dolor pleurítico, epigastralgia y tos con expectoración blanquecina; se realizó una endoscopia de vías digestivas altas que mostró una mucosa gravemente inflamada con ulceraciones irregulares de hasta 2 cm de profundidad, lesiones que sugirieron tuberculosis esofágica, confirmada por el estudio histopatológico: esofagitis crónica granulomatosa; por tanto, se inició el tratamiento tetraconjugado: rifampicina, isoniazida, pirazinamida y etambutol. Conclusiones: La tuberculosis con afección del tubo digestivo es una entidad de baja frecuencia; adicionalmente, es importante recordar que la gravedad del cuadro clínico usualmente está relacionada con la coinfección por el virus de la inmunodeficiencia humana (VIH), y que la asociación de ambas patologías es frecuente.

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Section: Discussionunclassified

Tuberculosis esofágica asociada con inmunosupresión por VIH: reporte de caso

Ortiz¹,

Mesa²,

Acosta³

et al. 2021

Rev colomb Gastroenterol

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“…On esophagoscopy, the endoscopic findings of ET are varied, such as mucosal or submucosal eminence lesion, ulcer, diverticulum and fistula formation [ 11 , 12 ]. In addition, esophagography and chest CT can only provide indirect esophageal images (although chest CT can also visualize changes from pulmonary tuberculosis).…”

Section: Discussionmentioning

confidence: 99%

EUS in the diagnosis of pathologically undiagnosed esophageal tuberculosis

et al. 2020

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Background: Esophageal tuberculosis (ET) is relatively rare, and the diagnosis is challenging. The aim of this study was to evaluate the clinical features of ET and highlight the role of endoscopic ultrasonography (EUS) in the diagnosis of pathologically undiagnosed ET. Methods: We retrospectively analysed the clinical features, radiological performances, conventional endoscopic appearances, EUS features, treatment and outcomes of pathologically undiagnosed ET between January 2011 and December 2018. All 9 patients failed to be diagnosed by at least two repeated biopsies (such as routine biopsy, multipoint or deep biopsy, and even or EUS-guided fine-needle aspiration (EUS-FNA)). Results: Nine patients (66.7% female) with a mean age of 45 years (range 29-59) complained of retrosternal pain or discomfort, or (and) dysphagia. Esophagoscopy demonstrated protruding lesions in the mucosa with central ulcers or erosion in five patients, submucosal bulges with smooth surfaces in one patient, submucosal bulges with diverticula in one patient, ulcers with suspicious fistula formation in one patient, and multiple ulcers in one patient. None of the patients received confirmed histopathological or bacteriological diagnoses by repeated biopsies. However, they were first suspected to have ET based on EUS examination. Because EUS found some characteristic ultrasonographic changes, which were very helpful for the diagnosis of ET when combined with clinical manifestations, the patients subsequently received diagnostic antituberculosis therapy. Finally, the patients recovered or improved with follow-up times ranging from 3 to 10 months. Conclusions: EUS could help in the diagnosis of ET on basis of EUS features like poorly defined esophageal wall structure, enlarged paraesophageal or mediastinal lymph nodes, hypoechoic lesions of esophageal wall that are linked to the enlarged paraesophageal lymph nodes. However all attempts should be made to obtain histological or microbiological diagnosis.

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“…Several acid‐fast bacilli (AFB) were detected. Therefore, the patient was diagnosed with primary esophageal TB 30 …”

Section: Esophageal Tuberculosismentioning

confidence: 99%

“…Therefore, the patient was diagnosed with primary esophageal TB. 30 EUS-FNA has helped remarkably with obtaining multiple and deep submucosal biopsies with no adverse events and provides a high diagnostic yield, estimated to be 94.3-100%. 9,31,32 In a study by Puri et al, EUS-FNA reportedly contributed to 72% of the diagnoses of esophageal TB cases.…”

Section: Endoscopic Ultrasound In Diagnosing Abdominal Tuberculosismentioning

confidence: 99%

Current role of endoscopic ultrasound for gastrointestinal and abdominal tuberculosis

et al. 2022

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A high incidence of tuberculosis (TB), especially in endemic countries, makes this infectious disease a concern. Abdominal TB contributes to 10% of extrapulmonary TB. Due to nonspecific clinical, radiological, and endoscopic findings, diagnosing abdominal TB continues to be a challenge. Hence, a precise diagnosis is needed. The diagnosis of gastrointestinal disease using endoscopic ultrasound (EUS) is often performed due to its high resolution and ability to provide a real-time visual representation of the gastrointestinal tract and extramural structures. EUS-guided fine-needle aspiration (FNA) and fineneedle biopsy (FNB) have helped diagnose TB as they offer an adequate specimen for cytology or histopathological examination. This method is considered safer, more effective, and more efficient. The capacity of EUS to diagnose abdominal TB based on the affected organs was examined via a literature search. We reviewed the role of EUS in diagnosing esophageal, gastric, pancreatic, peripancreatic, hepatosplenic, peritoneal, and intestinal TB. Generally, EUS aids in diagnosing abdominal TB. In some organs, it is superior to other diagnostic modalities. However, further examinations, such as cytology or histopathology and microbial, are still needed. We also studied the roles of EUS-FNA and EUS-FNB. EUS-FNA has shown a high diagnostic yield in esophageal (94.3-100%), pancreatic and peripancreatic (76.2%), and intestinal TB (84.1%). As minimally invasive methods, EUS-FNA and EUS-FNB can successfully provide sufficient samples. EUS is a functional diagnostic modality for abdominal TB. EUS-FNA and EUS-FNB provide sufficient samples safely and efficiently for further cytology, histopathology, and microbial examinations. Esophageal tuberculosisEsophageal TB is uncommon and has nonspecific clinical, laboratory, radiological, and endoscopic features. With prevalence

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A case of esophageal tuberculosis with unusual endoscopic feature

Cited by 8 publications

References 4 publications

Tuberculosis esofágica asociada con inmunosupresión por VIH: reporte de caso

Tuberculosis esofágica asociada con inmunosupresión por VIH: reporte de caso

EUS in the diagnosis of pathologically undiagnosed esophageal tuberculosis

Current role of endoscopic ultrasound for gastrointestinal and abdominal tuberculosis

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