Mediastinal tuberculous lymphadenitis presenting as an esophageal intramural tumor: A very rare but important cause for dysphagia

Figure 2 A barium swallow esophagogram disclosing a four-centimeter protruding smooth lesion with apparent integrity of mucosa on the mid-esophagus (A, B), esophagoscopy showing a two-centimeter deformity of the esophageal wall covered by normal mucosa and with firm consistency, twenty-two centimeters from dental arch (C), endoscopic ultrasonography revealing a two-centimeter well defined solid tumor in the fourth layer (D), lymph node parenchyma extensively occupied by necrotizing epithelioid granulomas (HE, × 40) and typical tuberculous granuloma with central caseous necrosis and multinucleated cells of Langhans type (HE, × 200) (E), and a two-month follow-up after surgery revealing no filling defect at the same level (F).