Tissue sampling and histopathological limitations in esophageal cancer

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Abstract

Esophageal adenocarcinoma is a common gastrointestinal cancer. Esophagogastroduodenoscopy with biopsy and immunohistochemistry are used to detect the neoplasm at an early stage. Definitive diagnosis requires not only highly specialized equipment but also the skills of the endoscopist and pathologist. We report the case of a 35-year-old man with progressive dysphagia caused by gastroesophageal cancer. Numerous esophagogastroduodenoscopy studies, computed tomography, and barium X-ray swallow revealed an extensive esophageal lesion; however, pathomorphologic examinations did not confirm malignancy within a year. Histological studies showed pyloric gland adenoma and adenoma from parietal or oncocytic cells with high-grade dysplasia. Esophagogastroduodenoscopy with targeted biopsy at a specialized center confirmed the tumor malignancy. This clinical case demonstrates the importance of summing clinical symptoms and using additional instrumental methods to make a definitive diagnosis if biopsy results are ambiguous.

About the authors

Dina A. Akhmedzyanova

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies

Author for correspondence.
Email: AkhmedzyanovaDA@zdrav.mos.ru
ORCID iD: 0000-0001-7705-9754
SPIN-code: 6983-5991
Scopus Author ID: 58104960900
Russian Federation, Moscow

Olga K. Yutsevich

P.A. Herzen Moscow Oncology Research Institute, Branch, National Medical Research Radiological Center

Email: o.yutsevitch@yandex.ru
ORCID iD: 0000-0002-3860-9853
Russian Federation, Moscow

Roman V. Reshetnikov

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies

Email: r.reshetnikov@npcmr.ru
ORCID iD: 0000-0002-9661-0254
SPIN-code: 8592-0558

Cand. Sci. (Phys.-Math.)

Russian Federation, Moscow

Olga V. Tashchyаn

The First Sechenov Moscow State Medical University

Email: olgatash1@rambler.ru
ORCID iD: 0000-0001-6759-6820
SPIN-code: 3658-1120

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Sergey S. Pirogov

P.A. Herzen Moscow Oncology Research Institute, Branch, National Medical Research Radiological Center

Email: pirogov@mail.ru
ORCID iD: 0000-0002-8101-2155
SPIN-code: 7812-5502

MD, Dr. Sci. (Med.)

Russian Federation, Moscow

Maria P. Mazurova

P.A. Herzen Moscow Oncology Research Institute, Branch, National Medical Research Radiological Center

Email: mnioi_morphology@mail.ru
ORCID iD: 0000-0002-4873-4455
SPIN-code: 4455-3055

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Nadezhda N. Volchenko

P.A. Herzen Moscow Oncology Research Institute, Branch, National Medical Research Radiological Center

Email: mnioi_morphology@mail.ru
ORCID iD: 0000-0003-0421-4172

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

Aziz K. Kamalov

P.A. Herzen Moscow Oncology Research Institute, Branch, National Medical Research Radiological Center

Email: kak6768@mail.ru
ORCID iD: 0000-0001-7376-6056
SPIN-code: 1671-1600
Russian Federation, Moscow

Yuliya F. Shumskaya

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies

Email: ShumskayaYF@zdrav.mos.ru
ORCID iD: 0000-0002-8521-4045
SPIN-code: 3164-5518
Russian Federation, Moscow

Marina G. Mnatsakanyan

The First Sechenov Moscow State Medical University

Email: mnatsakanyan08@mail.ru
ORCID iD: 0000-0001-9337-7453
SPIN-code: 2015-1822

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. X-ray of the esophagus. Circular narrowing of the esophagus, a thin channel for the entry of barium suspension (indicated by an arrow).

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3. Fig. 2. Computed tomography of the chest organs. White arrows indicate pathological changes: a — neoplasm of the esophagus, spreading to the cardia of the stomach, 186 mm long; b - massive proliferation of tumor tissue with narrowing of the lumen in the middle third of the esophagus; c — tumor lesion of the regional para-aortic lymph node; d — narrowing of the lumen of the esophagus to 2 mm in the lower third.

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4. Fig. 3. Endophoto. Stenosing adenocarcinoma associated with Barrett`s esophagus. Blue arrows indicate areas of circularly located tumor.

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5. Fig. 4. Endophoto. Barrett`s stenosing adenocarcinoma. The yellow arrow marks the endoscope located at the entrance to the stomach, the green arrow marks the tumor tissue.

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