1
|
Chen SY, Xie ZF, Jiang Y, Lin J, Shi H. Modified endoscopic submucosal tunnel dissection for large esophageal submucosal gland duct adenoma: A case report. World J Gastrointest Surg 2023; 15:1000-1006. [PMID: 37342838 PMCID: PMC10277952 DOI: 10.4240/wjgs.v15.i5.1000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/20/2023] [Accepted: 03/30/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND With the recent improvement of endoscopic techniques, endoscopic ultrasound-guided fine needle aspiration and endoscopic submucosal tunnel dissection (ESTD) have been widely used for accurate diagnosis and dissection acceleration of esophageal tumors.
CASE SUMMARY We used a modified submucosal tunnel technique during endoscopic en bloc resection in a 58-year-old man with large esophageal submucosal gland duct adenoma (ESGDA). During modified ESTD, the oral end of the involved mucosa was cut transversely, followed by a submucosal tunnel created from the proximal to the distal end, and the anal end of the involved mucosa blocked by the tumor was incised. As a result of retaining submucosal injection solutions using the submucosal tunnel technique, it was possible to reduce the amount of injection required and increase the efficiency and safety of dissection.
CONCLUSION Modified ESTD is an effective treatment strategy for large ESGDAs. Single-tunnel ESTD appears to be a time-saving procedure compared with conventional endoscopic submucosal dissection.
Collapse
Affiliation(s)
- Su-Yu Chen
- Department of Endoscopy Center, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, Fujian Province, China
| | - Zhao-Fei Xie
- Department of Endoscopy Center, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, Fujian Province, China
| | - Yan Jiang
- Department of Endoscopy Center, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, Fujian Province, China
| | - Juan Lin
- Department of Endoscopy Center, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, Fujian Province, China
| | - Hong Shi
- Department of Endoscopy Center, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, Fujian Province, China
| |
Collapse
|
2
|
Abstract
Submucosal glands (SMGs) present throughout human esophagus with clusters at either the upper third or lower third of the organ. SMGs tend to atrophy with age, and neoplasms arising in these glands are rare. In order to bring convenience to diagnosis, we summarize the histopathologic characteristics of all esophageal submucosal gland tumors (SGTs). Due to the morphological similarity, the nomenclature of salivary tumors is adopted for SGTs. However, there is great confusion about the definition and histogenesis of these tumors, especially the malignant subtypes. In the literature, esophageal mucoepidermoid carcinoma and adenoid cystic carcinoma usually adjoin the surface squamous epithelium and coexist with intraepithelial neoplasia or invasive squamous cell carcinoma (SCC). In addition, the typical gene alterations of salivary tumors have not been reported in these SGTs. Therefore, we propose to apply stringent diagnostic criteria to esophageal SGTs so as to exclude mimickers that are SCCs with various degree of SMG differentiation.
Collapse
|
3
|
Endoscopic findings of esophageal submucosal gland duct adenoma. VIDEOGIE : AN OFFICIAL VIDEO JOURNAL OF THE AMERICAN SOCIETY FOR GASTROINTESTINAL ENDOSCOPY 2019; 4:361-363. [PMID: 31388611 PMCID: PMC6669342 DOI: 10.1016/j.vgie.2019.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
4
|
Nie L, Wu HY, Shen YH, Fan XS, Sun Q, Huang Q, Chen J. Esophageal submucosal gland duct adenoma: a clinicopathological and immunohistochemical study with a review of the literature. Dis Esophagus 2016; 29:1048-1053. [PMID: 26542981 DOI: 10.1111/dote.12442] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Esophageal submucosal gland duct adenoma (ESGDA) is a rare tumor. The clinicopathological features of the ESGDA and its precursor lesion have not been comprehensively evaluated. In this study, we aimed at delineating the clinicopathological features of the ESGDA and cyst formation of the esophageal submucosal gland duct (ESGD), as well as their correlations and clinical implications. We identified three cases of ESGDA and 16 cases of cyst formation of the ESGD among 786 endoscopic mucosal resection specimens over a 7-year period. The median patient age was 58 years with a male predominance. These lesions were small submucosal bulges locating at the lower esophagus with a size no more than 1 cm. The main microscopic changes of these lesions included content retention, multilayered epithelium or papillary folds of the ESGD and inflammatory cell infiltration, acidophilic degeneration, hyperplasia or atrophy of the acini. The included cases generally showed moderate to severe microscopic esophagitis. The ESGDA was mainly consisted by multiple glandular cysts covered by two layers of cells. Immunohistochemical results showed that the luminal duct lining cells and basal cells were positive for CK7 and p63, respectively. Both of the two layer cells were positive for HMWCK and negative for CK20, p53, CDX2, MUC5AC, MUC6, MUC2 and MUC1. The proliferation index was very low (1%). The diagnostic criteria of the ESGDA were proposed and, the differential diagnosis was discussed. Cyst formation of the ESGD is considered to be the precursor lesion of the ESGDA, because they have overlapping clinicopathological features with progressive relationship. In addition, the ESGDA have close connection with advance of the GERD and, probably, an increased risk of carcinoma.
Collapse
Affiliation(s)
- L Nie
- Department of Pathology, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - H Y Wu
- Department of Pathology, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Y H Shen
- Gastroenterology, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - X S Fan
- Department of Pathology, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Q Sun
- Department of Pathology, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Q Huang
- Department of Pathology and Laboratory Medicine, Veterans Affairs Boston Healthcare System and Harvard Medical School, Boston, Massachusetts, USA
| | - J Chen
- Department of Pathology, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu Province, China
| |
Collapse
|
5
|
Moreman C, Budihal S, Ubhi S, de Caestecker J, Richards CJ. An unusual cause of odynophagia. Gut 2016; 65:399, 534. [PMID: 26423111 DOI: 10.1136/gutjnl-2015-310115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 08/24/2015] [Indexed: 12/08/2022]
Affiliation(s)
- Catherine Moreman
- Department of Histopathology, University Hospitals of Leicester, Leicester, UK
| | - Shivkumar Budihal
- Digestive Diseases Centre, University Hospitals Leicester, Leicester, UK
| | - Sukhbir Ubhi
- Department of Surgery, University Hospitals of Leicester, Leicester, UK
| | - John de Caestecker
- Digestive Diseases Centre, University Hospitals Leicester, Leicester, UK
| | - Cathy J Richards
- Department of Histopathology, University Hospitals of Leicester, Leicester, UK
| |
Collapse
|
6
|
Kim Y, Park YS, Bang JS, Kim JY, Ko YH, Park CK, Kim KM. Esophageal Gland Duct Adenoma. KOREAN JOURNAL OF PATHOLOGY 2011. [DOI: 10.4132/koreanjpathol.2011.45.s1.s45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Yoonjung Kim
- Department of Pathology, Seoul Veterans Hospital, Seoul, Korea
| | - Yang-Soon Park
- Department of Pathology, Seoul Veterans Hospital, Seoul, Korea
| | - Jei So Bang
- Department of Internal Medicine, Seoul Veterans Hospital, Seoul, Korea
| | - Ji Yeon Kim
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young-Hyeh Ko
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Cheol Keun Park
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyoung-Mee Kim
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
7
|
Harada O, Ota H, Katsuyama T, Hidaka E, Ishizaka K, Nakayama J. Esophageal gland duct adenoma: immunohistochemical comparison with the normal esophageal gland and ultrastractural analysis. Am J Surg Pathol 2007; 31:469-75. [PMID: 17325490 DOI: 10.1097/01.pas.0000213400.64945.9e] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Esophageal gland duct adenomas are extremely rare tumors. Here, we report the case of a 75-year-old Japanese man who had undergone total gastrectomy for advanced gastric cancer. Esophageal gland duct adenoma was incidentally found in the lower esophagus. It appeared to be detached from the site of gastric cancer and was well demarcated without a capsule. Histologic analysis revealed papillary and cystic structures mainly comprising eosinophilic cells with minimum nuclear atypia. Immunohistochemical analysis revealed that the tumor were diffusely positive for the S100 protein with preserved alpha-SMA-positive myoepithelial cell layers and a characteristic cytokeratin expression pattern similar to that in normal esophageal gland ducts (CK5/6+++, CK7+++, CK17+, CK18+, CK19+++, CK20-, HMWCK+++). In addition, differentiation into the terminal duct was confirmed by a combination of mucin staining and immunohistochemical and ultrastructural examinations. This is the first report that refers to the ultrastructural findings of an esophageal gland duct adenoma and describes terminal duct differentiation. We believe that the possibility of an esophageal gland duct adenoma should be considered when diagnosing a ductal or glandular lesion of the esophagus.
Collapse
Affiliation(s)
- Oi Harada
- Department of Pathology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
| | | | | | | | | | | |
Collapse
|
8
|
Shirahige A, Mizushima T, Ohbayashi C, Matsushita K, Tanioka H, Hanahusa S, Soda M, Ochi K, Koide N, Tanimoto M. A CASE OF SIALADENOMA PAPILLIFERUM OF THE ESOPHAGUS. Dig Endosc 2005. [DOI: 10.1111/j.1443-1661.2005.00554.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
|
9
|
Matsushita M, Okazaki K. Esophageal, submucosal, gland duct adenoma: role of EUS for endoscopic removal. Gastrointest Endosc 2005; 61:790; author reply 790-1. [PMID: 15856000 DOI: 10.1016/s0016-5107(05)00142-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
|