Endoscopic ultrasound in the diagnosis of esophageal tubercular stricture

Esophageal tuberculosis is a rare form of extrapulmonary tuberculosis, accounting for up to 0.2% of all tuberculosis cases, and concomitant pulmonary lesions are observed in fewer than 50% of cases.The clinical presentation of esophageal tuberculosis often mimics that of esophageal strictures of any etiology, which can delay diagnosis.Herein, we report the case of a 16-year-old girl who presented with odynophagia, progressive dysphagia, and weight loss.Upper gastrointestinal endoscopy revealed esophageal stricture with adjacent linear ulcerations, but biopsy results were inconclusive.Endoscopic ultrasonography-guided fine-needle aspiration cytology confirmed the diagnosis of tubercular esophageal stricture.The patient responded well to antituberculosis therapy, with resolution of symptoms and complete healing of the esophageal ulcerations.This case highlights the importance of considering esophageal tuberculosis in the differential diagnosis of dysphagia, particularly in tuberculosis-endemic regions, and underscores the role of endoscopic ultrasound in establishing the diagnosis and guiding appropriate treatment for this rare presentation of extrapulmonary tuberculosis.