Cases reported "Esophageal Neoplasms"

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1/10. Esophageal carcinoma showing a long stricture due to prominent lymphatic permeation: report of a case.

    Some esophageal diseases such as carcinoma, esophagitis, and collagen diseases have often been reported to show a diffusely thickened esophageal wall in the roentogenogram findings. In the current report, a preoperative upper gastrointestinal series and an endoscopic examination showed a diffusely infiltrative type carcinoma, but other examinations did not suggest any diseases such as esophagitis or collagen diseases which might cause a thickening of the esophageal wall or a constriction of the esophagus. A postoperative histological examination revealed the primary carcinoma to remain only within the mucosal layer, while a large degree of lymphatic vessel permeation reached the adventitia over a wide area. An extraordinary degree of lymphatic permeation spread through the esophageal wall, and stromal fibrosis developed as a result of such lymphatic permeation. These histological phenomena might thus have led to the macroscopic appearance of infiltrative type esophageal carcinoma.
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keywords = esophageal disease
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2/10. Multifocal squamous cell carcinoma of the oesophagus following radiotherapy for bilateral breast carcinoma.

    A 60 year old woman who presented with dysphagia and weight loss was found to have multiple foci of dysplasia and in situ and invasive squamous cell carcinoma scattered along the whole length of the oesophagus, with intervening areas of normal mucosa. The patient had a history of two breast carcinomas 19 and one year previously for which she had repeated radiotherapy. Several members of the patient's close family had histories of malignant disease. All oesophageal lesions and the more recent breast cancer showed positive immunostaining for p53 protein. p53 mutations, some involving different exons, were also detected in these lesions. No p53 immunostaining or mutations were detected in the normal oesophageal mucosa. The findings suggest an independent origin of the multiple dysplastic and neoplastic foci, which might have developed in a background of a field change, possibly related to the previous radiotherapy. The strong family history of malignant diseases raises the possibility that, in addition, genetic factors might have played a role in the development of the oesophageal disease.
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keywords = esophageal disease
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3/10. Dysphagia in a patient with a history of large B-cell lymphoma: esophageal disease with negative biopsy findings.

    A patient with a previous diagnosis of lymphoma showed signs of dysphagia. endoscopy found a lesion of the esophagus. Brush cytology and biopsy sampling were accomplished. The biopsy showed inflammation and granulation tissue but no tumor. The cytology specimen, however, was diagnostic of lymphoma. This case emphasizes the need for obtaining cytologic specimens concurrently with biopsies of esophageal lesions.
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keywords = esophageal disease
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4/10. Pericardial repair of a tracheal laceration during transhiatal esophagectomy.

    Transhiatal esophagectomy has recently been popularized for both benign and malignant esophageal disease. While we were performing a transhiatal esophagectomy for a squamous cell cancer of the upper third of the esophagus, a tear in the membranous trachea near the carina occurred. This was repaired through the cervical incision with a free pericardial patch. This solution to a potentially catastrophic complication of transhiatal esophagectomy gave a satisfactory result without early or late postoperative respiratory complications.
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keywords = esophageal disease
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5/10. diagnosis and management of diffuse leiomyomatosis of the oesophagus.

    Diffuse leiomyomatosis of the oesophagus is a rare entity among oesophageal diseases. Histopathologically it is characterized by diffuse hypertrophy of the muscular layer extending to the whole oesophagus predominantly in the lower third, where it can result in tumour formation. leiomyomatosis can involve the upper part of the stomach and is frequently associated with genital or tracheobronchial (bronchitracheal) muscular localizations. Also, it can be associated with Alport's syndrome in familial cases. For diagnosis, barium swallow, computerized tomography (CT) scan and, in recent years, endoscopic ultrasonography are used. Oesophageal resection is the only suitable treatment in symptomatic cases. We report three observations during 1979-95.
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keywords = esophageal disease
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6/10. Bronchogenic carcinoma masquerading as primary esophageal disease.

    This report describes our experience with six patients with dysphagia as the sole manifestation of radiographic, inconspicuous primary lung cancer and well-defined esophageal lesion by barium swallow. Esophagograms suggested leiomyoma, benign esophageal stricture, duplication cyst, achalasia, and primary carcinoma of the esophagus. Careful evaluation of the chest radiographs in all patients presenting with dysphagia is emphasized. The majority of esophageal findings are subcarinal and bronchoscopy should be considered essential in the workup of these patients.
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ranking = 4
keywords = esophageal disease
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7/10. Occult bronchogenic carcinoma masquerading as esophageal cancer. case reports with recommendations for a change in reporting esophageal cytology.

    We describe two patients with benign esophageal stricture in whom exfoliative esophageal cytologic features positive for squamous cell carcinoma is attributed to roentgenographically occult lung cancer. The discovery of alveolar macrophages within the esophageal washings of these patients prompted a retrospective analysis assessing the prevalence of esophageal washings contaminated by cellular material from the lower respiratory tract. Alveolar macrophages were observed in 11 of 28 patients (39%) and in 12 of 33 specimens (36%). Alveolar macrophages were noted in half of patients with benign esophageal disease, but in only one of eight cases with proved esophageal cancer. Criteria alerting physicians to the coexistence of benign esophageal stricture and occult respiratory neoplasm are given, and recommendations for a change in reporting esophageal cytologic features are proposed.
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keywords = esophageal disease
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8/10. Asymptomatic esophageal carcinoma with esophagopulmonary fistula masquerading as a primary lung abscess.

    A 58-year-old man presented with the clinical signs and symptoms of a large right upper lobe lung abscess. His course was complicated by diffuse bilateral necrotizing pneumonitis, and death occurred as a result of massive aspiration of lung abscess contents into uninvolved lung. At postmortem examination, an esophageal carcinoma with a direct fistulous communication with the abscess cavity was present. Although rare, asymptomatic malignant esophageal disease should be considered in the differential diagnosis of a lung abscess which does not follow a typical course.
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keywords = esophageal disease
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9/10. Permanent extracorporeal esophagogastric tube for esophageal replacement.

    Six patients are presented in whom an extracorporeal esophagogastric tube bypass was employed in lieu of standard methods of esophageal reconstruction. These tubes, obtained from japan, have functioned well in 4 of the 6 patients. This approach offers an alternative to gastrostomy feedings alone in a patient with advanced esophageal disease in whom no other method of surgical reconstruction can be offered.
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keywords = esophageal disease
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10/10. Hodgkin's disease of the esophagus.

    A 61-year-old man with acquired immunodeficiency syndrome (AIDS) sought care because of the onset of progressive dysphagia. He was found to have a perforated, fungating esophageal mass. The combined histologic and immunologic findings were diagnostic of Hodgkin's disease, nodular sclerosis type, lymphocyte-depleted variant, arising in the esophagus. The reed-sternberg cells and mononuclear variants were positive for Epstein-Barr virus (EBV) latent membrane protein (LMP1) and EBV rna. Occasional small lymphoid cells were also positive for EBV rna. polymerase chain reaction studies demonstrated the presence of EBV type A without deletion of the EBV LMP1 gene. Other authors have reported an increased frequency of type B EBV and deletion of the EBV LMP1 gene in cases of human immunodeficiency virus-associated Hodgkin's disease. Hodgkin's disease arising in the esophagus is rare in immunocompetent patients. However, in the presence of AIDS, Hodgkin's disease should be considered in the differential diagnosis of patients with signs or symptoms of esophageal disease.
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keywords = esophageal disease
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