Oesophageal tuberculosis mimicking oesophageal carcinoma

VKS Leung, WH Chan, TL Chow, ISC Luk, TN Chau, TKL Loke
Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong

Tuberculous involvement of the oesophagus is rare, and is usually caused by direct spread from adjacent afflicted structures. We report an 83-year-old male patient with oesophageal tuberculosis secondary to tuberculous mediastinal lymphadenitis who presented with non-specific symptoms of anorexia and lethargy. Upper gastro-intestinal endoscopy revealed an ulcerative tumour-like lesion in the mid-oesophagus suggesting oesophageal carcinoma. Repeated endoscopic biopsies revealed a non-specific acute-on-chronic inflammation consisting of non-caseating granulomas, with no evidence of malignancy. Endoscopic ultrasonography demonstrated that the oesophageal lesion was secondary to direct extension of mediastinal lymphadenopathy. The diagnosis of tuberculosis was eventually confirmed by histological and microbiological analysis of a surgically excised cervical lymph node. The patient responded promptly to treatment with antituberculous drugs. We suggest that oesophageal tuberculosis has to be kept in mind in the differential diagnosis of oesophageal ulcerohypertrophic lesions.

Hong Kong Med J 2006;12:473-6

Key words: Esophageal diseases; Tuberculosis, lymph node

View this abstract indexed in MEDLINE:


The Hong Kong Medical Journal is a continuation of the former Journal of the Hong Kong Medical Association.
The Hong Kong Medical Journal is published by the Hong Kong Academy of Medicine and the Hong Kong Medical Association.
Copyright © 1995-2014 HKAM. All rights reserved.
URL: http://www.hkmj.org
Layout, design, and revisions Copyright © 2014 HKAM.
Revised 9 December 2014