Clinical analysis of 8 cases of esophageal violated by mediastinal lymphoid tuberculosis

Objective To investigate the clinical features and management of esophageal violated by mediastinal lymphoid tuberculosis and improve the recognization and reduce misdiagnosis of the disease.Methods The clinical datas of eight patients with esophageal violated by mediastinal lymphoid tuberculosis were reviewed,3 were male,5 were femal,age ranged from 43 to 65 years old,the course ranged from 30 days to 1 years.The symptoms include:dysphagia,choking feeling of eating,chest pain.All the patients had no evidence of tuberculosis(TB)in the other part of the body.All the patients had esophagoscopy,5 cases showed compressive changes,1 case showed the narrowing of local stenosis.The 6 patients diagnosed as leiomyoma of esophagus did not perform the biopsy,2 cases revealed ulcerative damges,biopsy showed chronic inflammation.All the patients found no evidence of TB under esophagoscopy and biopsy.All patients had barium swallows,6 patients revealed leiomyoma of esophagus,2 patients revealed esophageal carcinoma.Two patients were misdiagnosed as carcinoma of the esophagus and 6 patients were misdiagnosed as leiomyoma of esophagus before operation,and they were operated,6 patients underwent thoracotomy and mediastinal lymph node dissection,the intraoperative frozen pathology showed lymphatic ulcer.Two patients underwent mediastinal lymph node dissection and cervical and esophagogastric anastomosis,the intraoperative frozen pathology showed tuberculous ulcers.The antituberculous drugs were administered in all the patients for I year.Results All the patients recovered well,and were followed-up for 1-10 years,with no dysphagia or recurrence of tuberaulosis.Conclusions Mediastinal lymphoid tuberculosis is a rare disease,and esophageal violated by mediastinal lymphoid tuberculosis with gradually growing up is very rare.The clinical manifestations are not specific,radiology and endoscopy are difficult to confirm the diagnosis,and it is usually mistaken for the esophageal tumor.For the patients can not confirm the diagnosis,or other lesions can not be excluded,surgery should be considered,and the antituberculous drugs should be administered after operation.The quality of long-term survival are superior after operation. Key words: Mediastinal lymphoid tuberculosis; Esophageal; Antituberculous chemotherapy