Tissue sampling and histopathological limitations in esophageal cancer

Abstract

Esophageal adenocarcinoma is a common gastrointestinal cancer. Esophagogastroduodenoscopy with biopsy and immunohistochemistry are used to detect the neoplasm at an early stage. Definitive diagnosis requires not only highly specialized equipment but also the skills of the endoscopist and pathologist. We report the case of a 35-year-old man with progressive dysphagia caused by gastroesophageal cancer. Numerous esophagogastroduodenoscopy studies, computed tomography, and barium X-ray swallow revealed an extensive esophageal lesion; however, pathomorphologic examinations did not confirm malignancy within a year. Histological studies showed pyloric gland adenoma and adenoma from parietal or oncocytic cells with high-grade dysplasia. Esophagogastroduodenoscopy with targeted biopsy at a specialized center confirmed the tumor malignancy. This clinical case demonstrates the importance of summing clinical symptoms and using additional instrumental methods to make a definitive diagnosis if biopsy results are ambiguous.

Keywords

esophageal adenocarcinoma / Barrett’s esophagus / gastroesophageal junction / esophagogastroduodenoscopy / computed tomography / biopsy

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Funding

Департамент здравоохранения города МосквыMoscow Health Care DepartmentMoscow Health Care Department(123031400009-1)

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