Brief reportMediastinal-esophageal fistulae after EUS-FNA of tuberculosis of the mediastinum
Section snippets
Case report
A 26-year-old man from India who lived in Northern Europe for 3 years presented with symptoms of weight loss (5 kg) and mediastinal lymphadenopathy (Fig. 1). He reported no cough, fever, or night sweats. Travel and family history were negative for TB. EUS-FNA of the subcarinal LN was performed based on the clinical suspicion of TB to obtain both a tissue diagnosis and material for TB culture.
With the patient under conscious sedation with midazolam, EUS was performed with a Pentax FG-34UX
Discussion
We report the occurrence of multiple mediastinal-esophageal fistulae after EUS-FNA of mediastinal LNs with TB. Patients with TB often present with mediastinal lymphadenopathy. The esophagus itself is rarely affected by TB.1 Although spontaneous fistulae formation of mediastinal LNs with TB of the esophagus can occur,2 in our opinion, it was an adverse event of EUS-FNA in this case. Esophageal-mediastinal fistulae often present with localized mediastinal gas collections,3 as observed in the case
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2011, Gastrointestinal EndoscopyCitation Excerpt :Needle core biopsy has been described as identifying granulomas from mediastinal tissue with tuberculosis.89 Mediastinal-esophageal fistulae after EUS-FNA of tuberculosis of the mediastinum have been reported.103 The following authors disclosed financial relationships relevant to this publication: Dr Decker: consultant to Facet Biotechnology; Dr Fanelli: honoraria from Ethicon, consultant to RTI; owner/governor: New Wave Surgical Corp; Dr Jain: research support from Barrx; Dr Evans: consultant to Cook Medical.