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EUS in the diagnosis of pathologically undiagnosed esophageal tuberculosis.
Zhu, Rong; Bai, Yonghua; Zhou, Yuankun; Fang, Xingguo; Zhao, Kui; Tuo, Biguang; Wu, Huichao.
Afiliação
  • Zhu R; Department of Gastroenterology, Affiliated Hospital, Zunyi Medical University, Zunyi, 563003, China.
  • Bai Y; Department of Pathology, Affiliated Hospital, Zunyi Medical University, Zunyi, 563003, China.
  • Zhou Y; Department of Gastroenterology, Affiliated Hospital, Zunyi Medical University, Zunyi, 563003, China.
  • Fang X; Department of Gastroenterology, Affiliated Hospital, Zunyi Medical University, Zunyi, 563003, China.
  • Zhao K; Department of Gastroenterology, Affiliated Hospital, Zunyi Medical University, Zunyi, 563003, China.
  • Tuo B; Department of Gastroenterology, Affiliated Hospital, Zunyi Medical University, Zunyi, 563003, China.
  • Wu H; Department of Gastroenterology, Affiliated Hospital, Zunyi Medical University, Zunyi, 563003, China. 18076207034@163.com.
BMC Gastroenterol ; 20(1): 291, 2020 Aug 28.
Article em En | MEDLINE | ID: mdl-32859167
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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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Tuberculose / Endossonografia Tipo de estudo: Diagnostic_studies / Observational_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Tuberculose / Endossonografia Tipo de estudo: Diagnostic_studies / Observational_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2020 Tipo de documento: Article