Case Report
Copyright ©2007 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 7, 2007; 13(45): 6104-6108
Published online Dec 7, 2007. doi: 10.3748/wjg.v13.i45.6104
Mediastinal tuberculous lymphadenitis presenting as an esophageal intramural tumor: A very rare but important cause for dysphagia
APA Pimenta, JR Preto, AMF Gouveia, E Fonseca, MML Pimenta
APA Pimenta, JR Preto, AMF Gouveia, Serviço de Cirurgia Geral, Porto Medical School and Hospital de São João, Porto, Portugal
E Fonseca, Pathology Department, Porto Medical School and Hospital de São João, Porto, Portugal
MML Pimenta, Radiology Department, Porto Medical School and Hospital de São João, Porto, Portugal
APA Pimenta, E Fonseca, Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Amadeu Pimenta, Professor, Serviço de Cirurgia Geral-Piso 6, Hospital de São João, E.P.E., Hernâni Monteiro, 4202-451 - Porto, Portugal.
Telephone: +351-22-5512308 Fax: +351-22-5512308
Received: August 15, 2007
Revised: September 22, 2007
Accepted: October 29, 2007
Published online: December 7, 2007

Dysphagia associated with esophageal mechanical obstruction is usually related to malignant esophageal diseases. Benign lesions are rarely a cause for this type of dysphagia, and usually occur either as an intramural tumor or as an extrinsic compression. Mediastinal tuberculous lymphadenitis is rare in adults, and even more rarely causes dysphagia. We report two cases of dysphagia in adult patients caused by mediastinal tuberculous lymphadenitis, presenting radiologically and endoscopically as an esophageal submucosal tumor. Based on the clinical and imaging diagnosis, the patients underwent a right thoracotomy, and excision of the mass attached to and compressing the esophagus. Pathological examination of the specimens showed a chronic granulomatous inflammation with caseous necrosis, which was consistent with tuberculous lymphadenitis.

Keywords: Dysphagia, Tuberculous lymphadenitis, Esophageal tumor, Uncommon dysphagia, Esophageal benign lesion