Pathologically and Bacteriologically Unconfirmed Esophageal Tuberculosis Diagnosed by Endoscopic Ultrasound Combined with the T-SPOT.TB test: A Case Report

Abstract

Esophageal tuberculosis (TB) is relatively a rare disease, and its diagnosis is often unknown due to the lack of specific clinical symptoms and endoscopic manifestations, as well as the low success rate of pathological biopsy. In this case report, we describe a patient who presented with dysphagia as the chief complaint, manifested as a submucosal eminence under endoscopy. Endoscopic ultrasonography showed hypoechoic changes, disappearance of some layers and esophageal boundaries, and echo of fused lymph nodes around the esophagus. The patient had strongly positive results of the purified protein derivative skin test and T-SPOT.TB. Subsequently, the patient received treatment of anti-TB drugs, and the clinical symptoms improved. According to the patient’s medical history and endoscopic ultrasonography results, esophageal TB was the most probable diagnosis. Therefore, this case report offers new ideas that endoscopic ultrasonography and a review of clinical manifestations can be used to diagnose esophageal TB.