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Debi U, Sharma M, Singh L, Sinha A. Barium esophagogram in various esophageal diseases: A pictorial essay. Indian J Radiol Imaging 2021; 29:141-154. [PMID: 31367085 PMCID: PMC6639862 DOI: 10.4103/ijri.ijri_465_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Recent years have seen a decline in number of barium procedures due to wider availability of cross sectional imaging modalities. Though use of barium esophagography/barium swallow has decreased in day to day clinical practice, it still remains a valuable test for structural and functional evaluation of esophagus. It can be performed as single or double contrast examination or as a multiphasic examination comprising upright double contrast views followed by prone single contrast views. This pictorial essay demonstrates imaging features of various esophageal diseases on barium esophagogram.
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Affiliation(s)
- Uma Debi
- Department of Radiodiagnosis and Imaging, PGIMER Chandigarh, India
| | - Madhurima Sharma
- Department of Radiodiagnosis and Imaging, PGIMER Chandigarh, India
| | - Lokesh Singh
- Department of Radiodiagnosis and Imaging, PGIMER Chandigarh, India
| | - Anindita Sinha
- Department of Radiodiagnosis and Imaging, PGIMER Chandigarh, India
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2
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Ishibashi N, Hata M, Maebayashi T, Aizawa T, Sakaguchi M, Okada M. Does protruding type 1 esophageal cancer really have a good response to radiation therapy?-a retrospective observational study. J Thorac Dis 2018; 10:3512-3518. [PMID: 30069348 PMCID: PMC6051799 DOI: 10.21037/jtd.2018.05.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 05/11/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND It is now well-established that esophageal cancer can be more accurately classified macroscopically on the basis of endoscopic rather than esophagographic findings. Thus far, no studies have reported correlations between responses to radiation therapy (RT) and endoscopically-determined macroscopic type of locally advanced esophageal cancer. In this retrospective study, we therefore aimed to determine such correlations in patients who had undergone at least two follow-up endoscopies. METHODS Our study cohort comprised 30 patients who had received radiotherapy for locally advanced squamous cell carcinoma (SCC) of the esophagus from January 2012 to November 2017 at our hospital. The lesions had been classified endoscopically into one of the five types specified by the Guidelines for Clinical and Pathologic Studies on Carcinoma of the Esophagus of the Japanese Society for Esophageal Disease. All patients had received radiotherapy and 27 had received chemotherapy. In accordance with those guidelines, responses to treatment were evaluated endoscopically, a median of 74 days after initiating radiotherapy. Follow-up endoscopy had been performed at least twice in 18/30 patients. RESULTS The primary complete response (CR) rate was significantly higher in patients with type 1 disease (protruding) than in those with the other types (χ2 test, P=0.041). The only correlation revealed by logistic regression analysis was between CR rate and macroscopically classified type 1 disease (P=0.05). Disease-specific survival (DSS) did not differ between macroscopically classified types (P=0.31). Patients with clinical T2 disease and ≤ stage IIIA had better outcomes than those with other stages (P=0.041 and 0.025, respectively). CONCLUSIONS Macroscopic classification of esophageal carcinoma by endoscopy accurately identifies a group with a higher primary CR rate to chemoradiotherapy (CRT): those with type 1 disease (protruding). However, median DSS did not differ between patients with type 1 disease and those with other types.
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Affiliation(s)
- Naoya Ishibashi
- Department of Radiology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Masaharu Hata
- Division of Radiation Oncology, Department of Oncology, Yokohama City University Graduate School of Medicine, Yokohama-shi, Kanagawa, Japan
| | - Toshiya Maebayashi
- Department of Radiology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Takuya Aizawa
- Department of Radiology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Masakuni Sakaguchi
- Department of Radiology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Masahiro Okada
- Department of Radiology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
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3
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Lee KH, Lee SJ, Kim HS, Kim SE, Choi SY, Lee HJ, Ha SH, Oh KH, Eom DW. A Case of Basaloid Squamous Cell Carcinoma of Polypoid Type in the Esophagus. Case Rep Gastroenterol 2017; 11:559-563. [PMID: 29033778 PMCID: PMC5637102 DOI: 10.1159/000479312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 07/07/2017] [Indexed: 12/02/2022] Open
Abstract
Basaloid squamous cell carcinoma of the esophagus is very rare. Further, polypoid type of esophageal cancer is also rare. We have recently treated a case of basaloid squamous cell carcinoma which presented as a 1.3-cm esophageal polyp. A 48-year-old woman was referred to our hospital because of a polypoid mass at 36 cm distance from the upper incisor on endoscopic examination, and the result of the biopsy was basaloid squamous cell carcinoma. The patient underwent Ivor Lewis operation with lymph node dissection. Two basaloid squamous cell carcinomas, of 1.3 and 0.4 cm, were diagnosed in the final pathologic examination. Regular periodic follow-up showed no evidence of recurrence or metastasis in the 5-month postoperative period.
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Affiliation(s)
- Ki Hun Lee
- Department of Internal Medicine, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Republic of Korea
| | - Sang Jin Lee
- Department of Internal Medicine, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Republic of Korea
| | - Hak Soo Kim
- Department of Internal Medicine, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Republic of Korea
| | - Sung Eun Kim
- Department of Internal Medicine, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Republic of Korea
| | - Soo Yong Choi
- Department of Internal Medicine, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Republic of Korea
| | - Hyun Ju Lee
- Department of Internal Medicine, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Republic of Korea
| | - Suk Hun Ha
- Department of Internal Medicine, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Republic of Korea
| | - Kwang Hoon Oh
- Department of Internal Medicine, Suncheon Hospital, Suncheon, Republic of Korea
| | - Dae-Woon Eom
- Department of Pathology, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Republic of Korea
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Lewis RB, Mehrotra AK, Rodriguez P, Levine MS. From the radiologic pathology archives: esophageal neoplasms: radiologic-pathologic correlation. Radiographics 2014; 33:1083-108. [PMID: 23842973 DOI: 10.1148/rg.334135027] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Esophageal neoplasms have a wide spectrum of clinical features, pathologic findings, and imaging manifestations. Leiomyomas are the most common benign esophageal neoplasm, typically appearing as smoothly marginated intramural masses. Fibrovascular polyps arise in the cervical esophagus, gradually elongating as they are pulled inferiorly by esophageal peristalsis. Granular cell tumors are generally incidental small intramural masses with an appearance similar to that of leiomyomas. Malignant esophageal neoplasms are a common cause of cancer mortality, particularly squamous cell carcinoma (SCC) and adenocarcinoma. Both of these tumors occur in older men, most often appearing as irregular infiltrative lesions at barium examination, with evidence of tumor spread beyond the esophagus at cross-sectional imaging. Adenocarcinoma arises from Barrett esophagus and is much more likely than SCC to involve the gastroesophageal junction. Esophageal involvement by lymphoma is usually secondary to tumor spread from the stomach or mediastinum. Spindle cell carcinoma is a biphasic malignancy with carcinomatous and sarcomatous elements that forms a bulky polypoid intraluminal mass. Neuroendocrine carcinoma is an aggressive neoplasm that may be hypervascular and is usually associated with metastatic disease at presentation. Understanding the imaging appearances and pathologic bases of esophageal neoplasms is essential for their detection, differential diagnosis, staging, and treatment planning.
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Affiliation(s)
- Rachel B Lewis
- American Institute for Radiologic Pathology, 1010 Wayne Ave, Suite 320, Silver Spring, MD 20910, USA.
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Saha S, Andley M, Gautam V, Gyan S, Kumar A, Kumar A. Carcinosarcoma of esophagus—a case report and review of literature. Indian J Thorac Cardiovasc Surg 2013. [DOI: 10.1007/s12055-013-0200-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Sadej P, Feld RI, Toll AD, Palazzo JP. AIRP Best Cases in Radiologic-Pathologic Correlation: Spindle Cell Carcinoma of the Esophagus. Radiographics 2011; 31:2035-9. [DOI: 10.1148/rg.317105214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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8
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Jakowski JD, Wakely PE. Rhabdomyomatous well-differentiated liposarcoma arising in giant fibrovascular polyp of the esophagus. Ann Diagn Pathol 2008; 13:263-8. [PMID: 19608085 DOI: 10.1016/j.anndiagpath.2008.04.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
We report an example of an esophageal giant fibrovascular polyp harboring a well-differentiated liposarcoma with rhabdomyomatous differentiation in a 68 year-old man. Initial imaging studies including fiberoptic endoscopy and 2 computed tomographic examinations, and laparoscopic myotomy failed to demonstrate the polypoid intraluminal nature of the lesion. Thus, alternative diagnoses including a malignant neoplasm and achalasia were entertained. A third computed tomography with contrast showed a pedunculated mass. Surgical resection revealed a 15-cm smooth-surfaced club-shaped mass composed of a well-differentiated liposarcoma demonstrating myoglobin, muscle-specific actin, and myogenin-positive rhabdomyomatous differentiation. To date, no previously reported giant fibrovascular polyp case has described a liposarcoma with rhabdomyomatous change.
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Affiliation(s)
- Joseph D Jakowski
- Department of Pathology, Ohio State University, College of Medicine, Columbus, OH 43210, USA
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Yanaga RH, Ledesma JA, Althoff CS, Soares MF. Carcinoma de células fusiformes de esôfago: relato de caso e revisão da literatura. Radiol Bras 2003. [DOI: 10.1590/s0100-39842003000200011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Lesões malignas do esôfago, excluindo-se carcinomas escamocelulares e adenocarcinomas, são bastante incomuns. Os autores relatam um caso de carcinoma de células fusiformes de esôfago. É um tumor maligno raro caracterizado por volumosa massa lobulada no terço médio do esôfago, que causa relativamente pequena obstrução apesar do seu volume. Em seguida é apresentada revisão da literatura sobre o assunto.
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11
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Levine MS. ESOPHAGEAL CANCER. Radiol Clin North Am 1997. [DOI: 10.1016/s0033-8389(22)00707-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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12
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Clark T, Lee MJ, Munk PL. Primary small-cell carcinoma of the oesophagus with spontaneous oesophageal perforation following chemotherapy. AUSTRALASIAN RADIOLOGY 1996; 40:250-3. [PMID: 8826728 DOI: 10.1111/j.1440-1673.1996.tb00396.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The authors describe a 66 year old woman with small-cell carcinoma of the oesophagus who developed a perforation following chemotherapy. Small-cell carcinoma of the oesophagus is a rare neoplasm, varying in appearance from a small mucosal lesion to a larger fungating mass, which in our patient presented as a bulky soft-tissue mass causing stricture. Pleural fluid collections which developed via a spontaneous oesophageal-pleural fistula were subsequently drained using percutaneously placed catheters. Radiologic management of this condition provided a successful and cost-effective means of patient care.
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Affiliation(s)
- T Clark
- British Columbia Cancer Agency, Department of Diagnostic Imaging, Vancouver, Canada
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Abstract
A case of the unusual condition of liposarcoma of the hypopharynx extending submucosally down the oesophagus in a 64 year old male is reviewed. The clinical, radiological and pathological features are presented and the role of various radiological modalities is discussed.
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Affiliation(s)
- N D Wambeek
- Department of Radiology, Royal Perth Hospital, Western Australia
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14
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Hunter JD, Thorogood SV, Williams MP. The radiological appearances of small cell (oat cell) carcinoma of the oesophagus. Clin Oncol (R Coll Radiol) 1995; 7:327-9. [PMID: 8580063 DOI: 10.1016/s0936-6555(05)80546-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We present three patients with primary small cell (oat cell) carcinoma of the oesophagus from a clinical and radiological point of view and review the radiological appearances of previously reported cases. The features of this rate neoplasm are variable, but extensive circumferential oesophageal wall thickening associated with luminal widening should raise the possibility of this diagnosis.
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Cooney BS, Levine MS, Schnall MD. Metastatic thyroid carcinoma presenting as an expansile intraluminal esophageal mass. ABDOMINAL IMAGING 1995; 20:20-2. [PMID: 7894291 DOI: 10.1007/bf00199636] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We report a patient with metastatic thyroid carcinoma invading the esophagus in whom barium and MR examinations revealed an expansile intraluminal mass indistinguishable from that of a primary esophageal malignancy. Metastatic thyroid carcinoma should therefore be included in the differential diagnosis of an expansile esophageal mass. As in our patient, MR imaging may be useful for showing that the mass originates in the thyroid gland.
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Affiliation(s)
- B S Cooney
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104
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Abstract
Polypoid carcinoma of the esophagus is rare and little is known about its clinical and histopathologic features. We reviewed 500 surgical cases of esophageal carcinoma and analyzed 12 polypoid carcinomas. Clinical records were reviewed. Histologic examination was done on an average of 68 sections in each tumor. Immunohistochemical examination for proliferating cell nuclear antigen (PCNA) was done in selected sections. No special findings were seen with respect to age, sex, symptoms, or tumor location. The tumors, however, had several interesting features: 1) the main histologic type was squamous cell carcinoma, but other histologic features such as so-called carcinosarcoma, adenoid cystic carcinoma, and verrucous carcinoma were occasionally seen, 2) bidirectional differentiation to squamous and adenocarcinomatous components was recognized, 3) intraepithelial spreading of the carcinoma was often present, 4) depth of invasion in the wall was often shallow, and 5) the prognosis was relatively good. The PCNA labeling index was well correlated with lymphatic or blood vessel permeation.
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Affiliation(s)
- M Mori
- Second Department of Surgery, Faculty of Medicine, Kyushu University, Fukuoka
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Mulder LD, Gardiner GA, Weeks DA. Primary small cell carcinoma of the esophagus: case presentation and review of the literature. GASTROINTESTINAL RADIOLOGY 1991; 16:5-10. [PMID: 1846835 DOI: 10.1007/bf01887291] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A case of primary small cell carcinoma of the esophagus is presented. The clinical, radiologic, and pathologic findings of our case and 72 other cases were reviewed. The most common presenting symptoms were weight loss and dysphagia. Eighty percent were larger than 4 cm at presentation and 97% were in the mid to distal esophagus. The esophageal tumors were identical histologically to small cell carcinoma of the lung. Esophageal luminal widening on esophagram has been found to be more common in nonsquamous cell carcinomas. While rare, small cell carcinoma should be considered in the differential diagnosis of primary esophageal tumors, particularly in the presence of these findings.
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Affiliation(s)
- L D Mulder
- Department of Radiology, Loma Linda University Medical Center, California 92354
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Abstract
Since 1971, 111 patients with esophageal carcinoma have undergone esophagectomy at the affiliated hospitals of Nippon Medical School. Of the 101 patients with ordinary squamous cell carcinoma, seven (7%) had intraluminal polypoid masses, endoscopically, and radiologically. The criteria used to select cases were as follows: (1) a size greater than 3 cm, (2) an intraluminal polypoid or pedunclated tumor, and (3) absence of wall construction and ulceration. Four of the seven polypoid cases have survived more than 5 years. One has lived more than 3 years. The 5-year survival rate of those patients with the polypoid type was 71%, but it was only 11% for the other types (P less than 0.05). Age, sex, size or location of the tumor, histologic grade, or lymph node metastasis did not affect survival. Only the incidence of adventitial involvement was significantly lower for the polypoid type. These results indicate that polypoid-type squamous cell carcinoma of the esophagus has a fairly good prognosis after surgery.
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Affiliation(s)
- K Sasajima
- First Department of Surgery, Nippon Medical School, Tokyo, Japan
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Abstract
Primary malignant melanoma of the oesophagus is an extremely rare tumour. The presentation of two such tumours in one hospital over a short period is thus unusual. The tumour is usually polypoid in nature, occurring anywhere in the oesophagus. Differentiation from other polypoid tumours by barium studies is very difficult, but at endoscopy primary melanoma has a characteristic appearance. At microscopy, junctional activity or atypical melanocytic hyperplasia are required to make the diagnosis. Treatment is surgical but the prognosis is very poor.
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Affiliation(s)
- J L Isaacs
- Department of Diagnostic Radiology, St James's Hospital, Leeds
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Abstract
A patient with giant fibroadipose polyp of the esophagus is reported. A new observation, a corrugated appearance localized to the segment of the esophagus containing the intraluminal tumor, is discussed. In addition, the computed tomography appearance of the tumor is presented.
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Affiliation(s)
- D R Radin
- Department of Radiology, University of Southern California School of Medicine, Los Angeles 90033
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