Esophageal Tuberculosis--2 Cases Report And Review Of The Literature

Objective Esophageal tuberculosis is rare. Most of the reported cases of esophageal tuberculosis are secondary to tubercular infection elsewhere in the body, especially pulmonary tuberculosis. Few cases of isolated or primary esophageal tuberculosis have been reported, and most of them have been from developing countries. There are no specific manifestations or laboratory findings, as well as typical X-ray evidence, histology, often fail to establish reliable diagnosis. Esophageal tuberculosis might be mistaken for esophageal carcinoma. We report 2 cases of esophageal tuberculosis to illustrate the clinical course and diagnostic problems of this condition. Our aim is to improve recognition and reduce misdiagnosis to esophageal tuberculosis. Methods A hospital-based, retrospective study was performed. Combining with review of literatures, we searched the database in our hospital between 2000 and 2002 and found 2 records diagnosed as esophageal tuberculosis. Both underwent endoscopic examination and biopsy. Results Both of the patients, who were female, presented with symptoms of esophageal lesion. Upon endoscopic examination, the sites of involvement were midesophagus in both cases, and each presented as isolatedulcerative lesion. For the first time, endoscopy was suggestive of malignancy not tuberculosis and pathological evidence was confirmed by repeated biopsy under endoscopy. Both patients received antitubercular therapy. Conclusion Esophagealtuberculosis is a rare disease, and it always involves the midesophagus, and the most predominant symptoms are dysphagia or chest pain. Diagnosis would be difficult even based on endoscopic examination and usually mistaken for carcinoma. In spite of its rarity, the differential diagnosis should be considered among uncertain esophageal lesions. Careful and repeated examination of cytological smears and biopsy appear essential and effective to the diagnosis. Most cases can be successfully treated with antitubercular chemotherapy or combined with surgery.