Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
권호 표지

Endoscopic Ultrasonographic Findings of Esophageal Tuberculosis: Case Report

식도 결핵의 내시경초음파 소견: 증례보고

  • Cho, Kyu-Hyun (Department of Internal Medicine, Catholic University of Daegu School of Medicine) ;
  • Jung, Jin-Tae (Department of Internal Medicine, Catholic University of Daegu School of Medicine) ;
  • Hur, Chang-Jae (Department of Internal Medicine, Catholic University of Daegu School of Medicine) ;
  • Kwon, Joong-Goo (Department of Internal Medicine, Catholic University of Daegu School of Medicine) ;
  • Kim, Eun-Young (Department of Internal Medicine, Catholic University of Daegu School of Medicine) ;
  • Oh, Hoon-Kyu (Department of Pathology, Catholic University of Daegu School of Medicine)
  • 조규현 (대구가톨릭대학교 의과대학 내과학교실) ;
  • 정진태 (대구가톨릭대학교 의과대학 내과학교실) ;
  • 허창재 (대구가톨릭대학교 의과대학 내과학교실) ;
  • 권중구 (대구가톨릭대학교 의과대학 내과학교실) ;
  • 김은영 (대구가톨릭대학교 의과대학 내과학교실) ;
  • 오훈규 (대구가톨릭대학교 의과대학 병리학교실)
  • Received : 2010.02.06
  • Accepted : 2010.04.03
  • Published : 2010.05.30
⟨ Previous Next ⟩

Abstract

Esophageal tuberculosis is a rare disease that is difficult to diagnose with esophagogastroduodenoscopy (EGD), endoscopic ultrasonography (EUS), and computerized tomography. The patients with esophageal tuberculosis show diverse endoscopic findings, but ulcerative lesion in the middle esophagus is usually found. In Korea, the endoscopic ultrasonographic findings of esophageal tuberculosis have not been described. The main endoscopic ultrasonographic findings of esophageal tuberculosis include heterogeneous or homogeneous hypoechoic masses in the esophageal wall with hyperechoic spots inside, interruption of the esophageal adventitia, and mediastinal lymphadenopathy. In this report, we describe two patients with esophageal tuberculosis, and they presented with submucosal tumor. In these patients, esophageal tuberculosis was diagnosed by EGD, EUS, and performing tuberculosis phase chain reaction on the endoscopic biopsies.

식도 결핵은 드문 질환으로 상부위장관 내시경 검사나 식도 조영술 및 흉부 전산화 단층촬영에서 진단하기 어렵다. 식도 결핵의 내시경 소견은 다양하나 주로 중부 식도 부위에 궤양형 병변을 보이는 경우가 많다. 내시경초음파에 대한 소견은 증례보고 만이 발표되어 있으며 국내보고는 아직 없는 실정이다. 식도 결핵의 주된 내시경초음파 소견은 식도벽내의 이질성 또는 균질성의 저에코 종괴모양으로 종괴내에 고에코성 반점이 대부분 나타나며 종격동 림프절이 커져 있고 식도 장막층의 파괴를 볼 수 있다. 저자들은 점막하 종양이 의심되어 전원된 환자들에서 상부위장관 내시경 검사 및 내시경초음파 검사를 시행하여 식도결핵으로 의심하고 조직검사 및 결핵 중합효소 연쇄반응에서 확진한 2예를 경험하였기에 문헌고찰과 함께 보고한다.

Keywords

References

  1. Kang JS, Oh SH, Kim SH, Paik NW. 4 cases of gastric tuberculosis. Korean J Gastroenterol 1996;28:561-565.
  2. Fahmy AR, Guindi R, Farid A. Tuberculosis of the oesophagus. Thorax 1969;24:254-256. https://doi.org/10.1136/thx.24.2.254
  3. Eng J, Sabanathan S. Tuberculosis of the esophagus. Dig Dis Sci 1991;36:536-540. https://doi.org/10.1007/BF01298890
  4. Sinha SN, Tesar P, Seta W, Sengupta SK. Primary oesophageal tuberculosis. Br J Clin Pract 1988;42:391-394.
  5. Aydin A, Tekin F, Ozutemiz O, Musoqlu A. Value of endoscopic ultrasonography for diagnosis of esophageal tuberculosis: report of two cases. Dig Dis Sci 2006;51:1673-1676. https://doi.org/10.1007/s10620-005-9028-6
  6. Marshall JB. Tuberculosis of the gastrointestinal tract and peritoneum. Am J Gastroenterol 1993;88:989-999.
  7. Cha JM, Lee JI, Choe JW, et al. A case of esophageal tuberculosis as the cause of a fever of an unknown origin. Korean J Gastrointest Endosc 2008;37:335-338.
  8. Kang SJ, Kim TH, Lee WH, et al. A case of tuberculosis of the esophagus and duodenum associated with pulmonary tuberculosis. Korean J Gastrointest Endosc 2007;35:165-169.
  9. Park JH, Kang HM, Kim MW, et al. A case of esophageal tuberculous abscess. Korean J Gastrointest Endosc 2005;31:252-256.
  10. Lee SY, Kim ES, Park SY, et al. A clinical study of esophageal tuberculosis: 3 cases report. Korean J Gastrointest Endosc 2002;25:192-197.
  11. Ye BD, Gwak GY, Kim W, et al. A case of esophageal tuberculosis initially presented as submucosal tumor. Korean J Gastroenterol 2001;38:203-206.
  12. Monig SP, Schmidt R, Wolters U, Krug B. Esophageal tuberculoisis: a differential diagnostic challenge. Am J Gastroenterol 1995;90:153-154.
  13. Jain SK, Jain S, Jain M, Yaduvanshi A. Esophageal tuberculosis: is it so rare? report of 12 cases and review of the literature. Am J Gastroenterol 2002;97:287-291. https://doi.org/10.1111/j.1572-0241.2002.05456.x
  14. Alatas F, Ozdemir N, Isiksoy S, et al. An unusual case of esophageal tuberculosis in an adult. Respiration 1999;66:88-90. https://doi.org/10.1159/000029346
  15. Gordon AH, Marshall JB. Esophageal tuberculosis: definitive diagnosis by endoscopy. Am J Gastroenterol 1990;85:174-177.
  16. Rosario MT, Raso CL, Comer GM. Esophageal tuberculosis. Dig Dis Sci 1989;34:1281-1284. https://doi.org/10.1007/BF01537279
  17. Park YB, Kim JI, Choo KY, et al. A case of primary esophageal tuberculosis confused as esophageal cancer. Korean J Gastrointest Endosc 2001;23:164-168.
  18. Han XM, Yang JM, Xu LH, Nie LM, Zhao ZS. Endoscopic ultrasonography in esophageal tuberculosis. Endoscopy 2008;40:701-702. https://doi.org/10.1055/s-2008-1077479