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Superficial pT1b-SM2 Barrett's Esophageal Carcinoma of Special Histological Type with Liver Metastasis, Report of a Case Manabu Takeuchi 1 , Gen Watanabe 2 , Satoru Hashimoto 3 , Yuichi Sato 1 , Ken-ichi Mizuno 3 , Masaaki Kobayashi 3 , Yoichi Ajioka 2 , Shuji Terai 1 1Department of Gastroenterology, Niigata University, Graduate School of Medical and Dental Sciences, Niigata, Japan 2Division of Molecular and Diagnostic Pathology, Niigata University, Graduate School of Medical and Dental Sciences, Niigata, Japan 3Department of Endoscopy, Niigata University Medical and Dental Hospital, Niigata, Japan Keyword: Barrett腺癌 , ESD , SM癌 , 肝転移 , 肺転移 pp.1177-1186
Published Date 2015/8/25
DOI https://doi.org/10.11477/mf.1403200389
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 A male in his seventies undergoing conventional esophagoscopy due to hematemesis was found to have a reddish, protruded, narrow-based lesion on the right wall of the SCJ(squamo-columnar junction). The background mucosa of the tumor was diagnosed as short-segment Barrett mucosa of the because of the presence of squamous islands on the distal side of SCJ. NBI(narrow band imaging)with magnification for this lesion revealed a high density of a small papillary/granular pattern with an irregular microvascular pattern.The initial tumor depth was identified as cT1a(M). However, the size of this tumor clearly increased with a firm consistently after 2 months, suggesting massive invasion of the submucosal layer. We performed ESD(endoscopic submucosal dissection)because of the absence of contraindications, including advanced age, previous severe complications, and lymph node or distant metastases on CT(computed tomography)examination. Histopathologically, the tumor was diagnosed as a 23 2315mm esophageal adenocarcinoma with partial squamoid(or basaloid)differentiation, pT1b(SM2, depth:approximately 3,000μ0), ly0, v1(marked), pHM0, and pVM0. The region of submucosal invasion demonstrated a special histological type that differed from the common histological type of Barrettccasion tionith n. evere complications, and y due to he at this time. Liver metastases were detected by abdominal CT at 4 months after ESD, and extended left hepatic lobectomy was performed. The histology of resected liver specimens resembled the region of primary submucosal invasion.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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