Esophagus - Adenocarcinoma Arising in Barrett's Staged with EUS FNA
Comments: We are examining the distal esophagus in a patient with a known adenocarcinoma of the esophagus. The purpose of this exam is to confirm the presence of the esophageal malignancy and to stage it with endoscopic ultrasound. One can appreciate Barrett's esophagus with features of malignancy. EUS is performed with a radial instrument and it demonstrates a hypoechoic infiltration of the distal esophagus. There is evidence of transmural invasion, as one can appreciate the hypoechoic infiltration extending through the wall and into the fat surrounding the esophagus. Additionally, hypoechoic, malignant-appearing lymph nodes are seen adjacent to the esophageal malignancy. A linear echoendoscopy is also performed and confirms the presence of an esophageal malignancy in the wall of the esophagus. Initially, there is no evidence of transmural invasion, but on closer examination, one can appreciate localized infiltration through the wall of the esophagus and into the surrounding fat. Fine needle aspiration is being performed of a large hypoechoic, malignant-appearing lymph node. To and fro motions with the needle will obtain cytological material from this lymph node and will demonstrate a T3N1 esophageal adenocarcinoma.
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William R. Brugge, M.D. Associate Professor of Medicine Harvard Medical School Massachusetts General Hospital |
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Citation: Brugge, WR (May 07 2004). Esophagus - Adenocarcinoma Arising in Barrett's Staged with EUS FNA. The DAVE Project. Retrieved Sep, 4, 2010, from http://daveproject.org/viewfilms.cfm?film_id=135 Times viewed since Feb 2006: 16883 |
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