CT manifestations of primary esophageal tuberculosis

Abstract

Background: Primary esophageal tuberculosis is an uncommon manifestation of Mycobacterium tuberculosis infection in Asian adults, often presenting with nonspecific symptoms that can complicate diagnosis. This report details a case of primary esophageal tuberculosis in middle age female, emphasizing the diagnostic value of computed tomography (CT) imaging. Case presentation: The patient, a 46-year-old female from Sichuan Province, China, experienced recurrent choking and mild retrosternal pain postprandially. She exhibited a weight loss of approximately 1 kg over a week, without additional symptoms such as dysphagia or fever. Esophagoscopy disclosed a small ulcer, and CT imaging revealed esophageal wall thickening with mucosal ulceration. A left thoracic lower and middle esophagectomy was conducted, with postoperative pathology confirming granulomatous inflammation, indicative of tuberculosis. Conclusions: This case highlights the pivotal role of CT imaging in diagnosing primary esophageal tuberculosis. The imaging modality’s ability to delineate subtle mucosal ulcerations and wall thickening provides a crucial diagnostic advantage, facilitating accurate and timely diagnosis of this rare condition.