Barrett's esophagus 1

CASE : 0004

Diagnosis & discussion


Final diagnosis

Well differentiated adenocarcinoma of Barrett's esophagus
Gross: type 0 IIa+IIc, Depth of invasion: pT1b-SM2, ly1/v0, DM0/PM0, pN(1/29)

Diagnosis & discussion

    Based on endoscopic and macroscopic findings in this patient, a diagnosis of adenocarcinoma developing in BE was difficult to make. However, detailed macroscopic observation including Lugol staining suggested a lesion located in the lower esophagus. In addition, confirmation of the extension of the Lugol-unstained mucosa around the lesion suggested the presence of BE.
    On histological examination, it is important to prepare serial cut sections on the esophageal side, and to confirm the histological images.
    In addition, as shown in biopsy diagnosis, even if the entire mucosal layer is collected, diagnosis of BE is difficult. A histological diagnosis of BE is appropriate only when a correct endoscopic diagnosis of BE has been made, and a histological specimen has been accurately collected from this BE area.
Contributor: Tadakazu Shimoda
Ichiro Oda
Institution: National Cancer Center
Country: Japan