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Multidrug-Resistant Tuberculous Mediastinal Lymphadenitis, with an Esophagomediastinal Fistula, Mimicking an Esophageal Submucosal Tumor
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Dongwuk Kim, Juwon Kim, Daegeun Lee, Ha Sung Chang, Hyunsung Joh, Won-Jung Koh, Jun Haeng Lee
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Clin Endosc 2016;49(6):564-569. Published online April 18, 2016
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DOI: https://doi.org/10.5946/ce.2016.020
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 Abstract
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- Mediastinal tuberculous lymphadenitis rarely mimics esophageal submucosal tumor, particularly in the case of multidrug-resistant tuberculosis (MDR-TB). Herein, we report the case of a 61-year-old woman who visited a local hospital complaining of odynophagia. An initial esophagogastroduodenoscopy revealed an esophageal submucosal tumor, and subsequent chest computed tomography showed subcarinal lymphadenopathy with an esophagomediastinal fistula. The patient was then referred to Samsung Medical Center, and a second esophagogastroduodenoscopy showed deep central ulceration, as well as a suspicious fistula in the esophageal submucosal tumor-like lesion. A biopsy examination of the ulcerative lesion confirmed focal inflammation only. Next, an endobronchial, ultrasound-guided lymph node biopsy was performed, and TB was confirmed. The patient initially began a course of isoniazid, rifampicin, ethambutol, and pyrazinamide. However, after a drug sensitivity test, she was diagnosed with MDR-TB, and second-line anti-TB medications were prescribed. She recovered well subsequently.
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Citations
Citations to this article as recorded by  - Detection of Esophageal Tuberculosis, a Rare Cause of Abdominal Pain, on18F-FDG PET/CT
Tarun Kumar Jain, Hemant Malhotra, Subhash Nepalia, Ganesh Narayan Saxena
Journal of Nuclear Medicine Technology.2024; 52(2): 179. CrossRef - Esophagomediastinal fistula secondary to tuberculous mediastinal lymphadenopathy
Ming-Dong Zhou, Dong-Ge Han, Wei Liu
Clinics and Research in Hepatology and Gastroenterology.2023; 47(10): 102243. CrossRef - “Esophagomediastinal fistula presenting as drug resistant tuberculosis”
Chinnu Sasikumar, Ketaki Utpat, Unnati Desai, Jyotsna M. Joshi
Indian Journal of Tuberculosis.2020; 67(3): 363. CrossRef - Tuberculous esophagomediastinal fistula with concomitant mediastinal bronchial artery aneurysm-acute upper gastrointestinal bleeding: A case report
Sultan R Alharbi
World Journal of Gastroenterology.2019; 25(17): 2144. CrossRef - Combined transbronchoscopic needle aspiration (TBNA) and rapid on-site cytological evaluation (ROSE) for diagnosis of tuberculous mediastinal lymphadenitis
Xi Dai, Bin Niu, Xiao-Qiong Yang, Guo-Ping Li
Medicine.2018; 97(37): e11724. CrossRef - Mediastinal Tuberculous Lymphadenitis Diagnosed by Endosonographic Fine Needle Aspiration
Joonhwan Kim, Youngwoo Jang, Kyung Oh Kim, Yoon Jae Kim, Dong Kyun Park, Dong Hae Chung, Eun Young Kim, Jun-Won Chung
The Korean Journal of Gastroenterology.2016; 68(6): 312. CrossRef
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