Detection of Esophageal Tuberculosis, a Rare Cause of Abdominal Pain, on¹⁸F-FDG PET/CT

The esophagus is rarely affected by Mycobacterium. A 75-y-old man presented with upper abdominal pain and significant weight loss for 2 mo. Contrast-enhanced CT, upper gastrointestinal endoscopy, and abdominal vessel angiography gave normal results. To clarify the facts, ¹⁸F-FDG PET/CT was performed, revealing an ¹⁸F-FDG–avid lesion in the posterior wall of the lower thoracic esophagus. On endoscopic ultrasound–guided fine-needle aspiration of this lesion, puslike material was released. On microscopic examination, acid-fast bacilli were noted. The patient then began receiving standard antitubercular therapy.