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Research Paper | Medical Science | Volume 15 Issue 6, June 2026 | Pages: 95 - 98 | India
Esophageal Ulcer-Unusual Presentation of Tuberculosis
Abstract: Esophageal tuberculosis (TB) is an extremely rare manifestation of gastrointestinal TB, accounting for approximately 0.3% of all GIT TB cases. It most commonly occurs secondary to contiguous spread from mediastinal lymph nodes and typically involves the middle third of the esophagus. Due to its rarity and nonspecific presenting symptoms, diagnosis is frequently delayed or overlooked. We report a case of a 26-year-old immunocompetent male who presented with progressive retrosternal chest pain and dysphagia for both solids and liquids. Upper GI endoscopy revealed a large mid-esophageal ulcer. CT thorax demonstrated mediastinal lymphadenopathy with necrotic areas. Endoscopic ultrasound-guided fine needle aspiration cytology (EUS-FNAC) from the lymph nodes revealed epithelioid granulomas with acid-fast bacilli, confirming tuberculous lymphadenitis. The esophageal ulcer biopsy demonstrated granulomatous inflammation. The patient was started on standard anti-tubercular therapy (HRZE for 3 months followed by HRE for 9 months) with proton pump inhibitors, resulting in complete endoscopic healing of the ulcer. This case highlights that esophageal TB must be considered as a differential diagnosis in patients with dysphagia and mediastinal lymphadenopathy, even in immunocompetent individuals in TB-endemic regions.
Keywords: Esophageal tuberculosis, dysphagia, mediastinal lymphadenopathy, anti-tubercular therapy, granulomatous esophagitis
How to Cite?: Dr. Pratish Surwase, Dr. Bhaskar Sinare, Dr. S. L. Tungikar, "Esophageal Ulcer-Unusual Presentation of Tuberculosis", Volume 15 Issue 6, June 2026, International Journal of Science and Research (IJSR), Pages: 95-98, https://www.ijsr.net/getabstract.php?paperid=SR26602184530, DOI: https://dx.dx.doi.org/10.21275/SR26602184530