RESUMEN
Esophageal involvement in tuberculosis is rare, and the clinical presentation may mimic an esophageal submucosal tumor. A 30-year-old woman presented with dysphagia for 1 month. At esophagoscopy, a 3-cm subepithelial mass with normal covering mucosa was found 28~25 cm from the upper incisors. We diagnosed the lesion as a submucosal tumor of the esophagus and performed endoscopic ultrasonography 1 week after the first examination. The second endoscopy showed a large, linear ulceration on the same subepithelial mass. The histologic examination obtained following an endoscopic biopsy revealed chronic granulomatous inflammation, and a molecular nested PCR study for Mycobacterium tuberculosis was positive. The final diagnosis was mediastinal tuberculous lymphadenitis with invasion into the esophagus. We suggest the use of molecular biology techniques when there is a strong clinical suspicion of tuberculosis and difficulty in arriving at a definite diagnosis.
Asunto(s)
Adulto , Femenino , Humanos , Biopsia , Trastornos de Deglución , Endoscopía , Endosonografía , Esofagoscopía , Esófago , Hidrazinas , Incisivo , Inflamación , Mediastino , Biología Molecular , Membrana Mucosa , Mycobacterium tuberculosis , Reacción en Cadena de la Polimerasa , Tuberculosis , Tuberculosis Ganglionar , ÚlceraRESUMEN
Aspergillus tracheobronchitis is one form of invasive pulmonary aspergillosis which is characterized by ulcers and pseudomembrane formation in tracheobronchial tree. In Aspergillus tracheobronchitis, the infection is often limited to the mucosa and it accounts for less than 10 percents of invasive disease. Invasive aspergillosis mainly occurs in immunocompromized patients with prolonged neutropenia, advanced AIDS, organ transplantation, high-dose glucocorticoid therapy or cytotoxic therapy although it can occur in less immunocompromised patients, such as after influenza, COPD, old age, and diabetes. We report a case of Aspergillus tracheobronchitis in a 61 year-old patient with diabetes and Child Pugh class A liver cirrhosis. He presented with cough and purulent sputum for 10 days. He was diagnosed by bronchoscopy and successfully treated with antifungal therapy.
Asunto(s)
Niño , Humanos , Aspergilosis , Aspergillus , Bronquitis , Broncoscopía , Tos , Diabetes Mellitus , Huésped Inmunocomprometido , Gripe Humana , Aspergilosis Pulmonar Invasiva , Cirrosis Hepática , Membrana Mucosa , Neutropenia , Trasplante de Órganos , Enfermedad Pulmonar Obstructiva Crónica , Esputo , Trasplantes , ÚlceraRESUMEN
Behcet's disease is chronic, relapsing, multi-systemic inflammatory vasculitis. Unlikely the other autoimmune diseases, gastric non-Hodgkin's lymphoma has rarely been reported in a patient with Behcet's disease. We report here on a 40-year-old man who had Behcet's disease for several years and who suffered recurrent oral ulcer, genital ulcer and skin lesion. The patient was treated with azathioprine and intermittent oral steroid. He complained of epigastric pain for 1 month, and he had a large ulcerative lesion seen on endoscopic evaluation. We confirmed the lesion was a gastric, diffuse, large B cell lymphoma by endoscopic biopsy. The patient was treated with the rituximab-CHOP regimen, and he has achieved a complete remission for 3 years. We report here on a case of gastric non-Hodgkin's lymphoma in a patient with Behcet's disease and who also had an ileocecal valve ulcer.