Esophageal polypoid dysplasia of gastric foveolar phenotype with focal intramucosal carcinoma associated with Barrett's esophagus

The American Journal of Surgical Pathology
Neil AsthanaSaverio Ligato

Abstract

We describe a rare case of esophageal polypoid dysplasia with gastric phenotype and focal intramucosal carcinoma associated with Barrett's esophagus. A 69-year-old man with a long history of gastroesophageal reflux disease was initially seen at an outside institution for evaluation of significant dysphagia. Screening upper gastrointestinal endoscopic evaluation revealed a large intraluminal polypoid lesion occluding the distal portion of the esophagus. Surgery was performed with resection of the distal esophagus and proximal stomach. The histopathologic examination of this lesion revealed an exuberant polypoid gastric epithelium with areas of low-grade dysplasia, high-grade dysplasia, and focal intramucosal carcinoma. A few residual foci of specialized intestinal metaplasia consistent with Barrett's esophagus without dysplasia were identified at the proximal and distal ends of the lesion. Immunohistochemically, this lesion revealed a pattern of expression of apomucins (MUC5AC diffusely positive, MUC1 and MUC6 focally positive, and MUC2 negative) consistent with a gastric foveolar phenotype. In addition, in the dysplastic areas, there was high Ki-67 labeling index and no overexpression of p53 protein. In our opinion, this case r...Continue Reading

References

Nov 2, 2001·The American Journal of Surgical Pathology·S C AbrahamT T Wu
Apr 26, 2003·Virchows Archiv : an International Journal of Pathology·M ViethM Stolte
Aug 20, 2003·Virchows Archiv : an International Journal of Pathology·Michal MichalZdenek Benes
Feb 25, 2005·Gastrointestinal Endoscopy·Junya OgumaMasaki Kitajima
Apr 20, 2005·Virchows Archiv : an International Journal of Pathology·Ryoji KushimaManfred Stolte
May 12, 2006·World Journal of Gastroenterology : WJG·Takashi YaoMasazumi Tsuneyoshi

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Citations

Oct 20, 2009·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Dipti MahajanMary P Bronner
Mar 17, 2010·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Ian S BrownGregory Y Lauwers
Sep 3, 2014·Journal of Clinical Pathology·Stefano Serra, Runjan Chetty
Jan 1, 2021·Histopathology·M Priyanthi KumarasingheSpiro C Raftopoulos

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