Endoscopic ultrasonography and histopathological analysis of misdiagnosed cases of esophageal epithelial malignant tumors
10.3760/cma.j.cn321463-20211021-00254
- VernacularTitle:食管上皮源性恶性肿瘤误诊病例的内镜超声及组织病理学特点分析
- Author:
Liangliang SHI
1
;
Nina ZHANG
;
Lin ZHOU
;
Yonghua SHEN
;
Tian YANG
;
Xiaoping ZOU
Author Information
1. 南京大学医学院附属鼓楼医院消化内科，南京 210008
- Keywords:
Diagnostic errors;
Esophageal neoplasms;
Submucosal tumors;
Endoscopic ultrasonography;
Histopathology
- From:
Chinese Journal of Digestive Endoscopy
2022;39(9):743-746
- CountryChina
- Language:Chinese
-
Abstract:
To analyze the endoscopic ultrasonography (EUS) and histopathological features of esophageal epithelial malignant tumors misdiagnosed as esophageal submucosal tumors (SMT), data of patients diagnosed as having esophageal SMT preoperatively but confirmed as esophageal epithelial malignant tumor by pathology after operation in Nanjing Drum Tower Hospital from January 2012 to December 2020 were retrospectively analyzed, and the clinical data including age, gender, size and location of the lesion, origin and echo of the lesion under EUS, endoscopic treatment and postoperative pathology were recorded. Among the 11 patients, there were 9 males and 2 females, aged (65.5±6.2) years. The length diameter of 9 lesions was ≤2 cm, and 8 lesions were located in the middle thoracic esophagus. Among the 11 patients, 10 underwent EUS before operation. The lesions originated from submucosa in 6 cases, muscularis propria in 2 cases and muscularis mucosa in 2 cases. The echo of the lesions was hypoechoic in 9 cases and isoechoic in only 1 case. Of the 11 patients, 3 underwent endoscopic mucosal resection, 6 underwent endoscopic submucosal dissection, and 2 underwent submucosal tunneling endoscopic resection. The histopathological types included 3 cases of moderately to poorly differentiated squamous cell carcinoma, 3 cases of basaloid squamous cell carcinoma, 2 cases of adenoid cystic carcinoma (including 1 case of adenoid cystic carcinoma colliding with squamous cell carcinoma), 2 cases of adenocarcinoma, and 1 case of esophageal sarcomatoid carcinoma with basaloid squamous cell carcinoma. Endoscopic manifestations of submucosal eminence in esophageal epithelial malignant tumors are extremely rare. EUS is helpful for differential diagnosis, and diagnostic treatment can make a definite diagnosis.
