PMC7299901_01
a: An esophagogastroduodenoscopy revealed a type-3 tumor at the middle intrathoracic esophagus. b: A barium esophagography also revealed an irregular stricture of the middle intrathoracic esophagus (white arrow).
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An esophagogastroduodenoscopy revealed a type-3 tumor at the middle intrathoracic esophagus (Fig. 1a), and a barium esophagography revealed an irregular stricture of the middle intrathoracic esophagus, measuring about 5 cm in length (Fig. 1b).
a, b: A CT scan revealed the upper mediastinal lymph node swelling and thickening of the esophageal wall.
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Endoscopic biopsy specimens taken from the tumor histologically showed poorly differentiated squamous carcinoma, and an enhanced computed tomography (CT) work-up revealed thickening of the esophageal wall and swelling of a mediastinal lymph node without any distant organ metastases (Fig. 2a, b).
a: The gross examination of the specimen showed a tumor measuring 45 x 15 mm in consonance with unstained area of iodine staining. b: The tumor invaded into the adventitia without exposure of the tumor (white arrow) (HE-stain, x 10). c: A high-power field revealed the tumor cells were poorly differeciated squamous cell carcinoma (HE-stain, x 40).
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The gross examination of the specimen showed that there was a type-3 tumor measuring 45 x 15 mm in consonance with an unstained area of iodine staining (Fig. 3a). Microscopic findings of the low-power field revealed invasion into the adventitia without exposure of the tumor (Fig. 3b), and those of high-power field also revealed poorly differentiated squamous cell carcinoma with multiple lymph node metastases; these findings led to a diagnosis of pT3N1M0 (Fig. 3c).
a: A chest X-ray at 7-year follow-up revealed a solitary pulomonary tumor at right lung (white arrow). b: A CT scan revealed the tumor with 1.5 cm of diameter. c: A PET-CT also showed the pulmonary tumor had abnormal uptake with 4.9 of standardized uptake value maximum.
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She was then followed for 6 years without recurrence; however, chest X-ray and CT examinations at the 7-year follow-up revealed a 1.5-cm-diameter solitary pulmonary tumor at right middle lobe with (Fig. 4a, b). In addition, positron emission tomography CT (PET-CT) also showed abnormal uptake of this pulmonary tumor (Fig. 4c).
a: A low-power field revealed that there was a well-demarcated tumor with necrotizing compartments (HE-stain, x 10). b: A high-power field also revealed that the tumor cells proliferated without having basement membrane-like structure (HE-stain, x 40).
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Microscopic findings of low-power field revealed that there was a solid tumor with necrotizing compartments, and those of high-power field also revealed that tumor cells proliferate without having a basement membrane-like structure (Fig. 5a, b).
An immunohistochemical examination revealed that the tumor cells of primary ESCC were positive for CK14 (a), CK18 (b), CK19 (c), and CK5/6 (d) (x 10).
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The tumor cells of primary ESCC were positive for CK14, CK18, CK19, and CK5/6 (Fig. 6a-d).
An immunohistochemical examination of the lung tumor also revealed that the tumor cells were negative for CK14 (a), napsin A (e), and synaptophysin (f). On the other hand, the tumor cells were strongly positive for CK18 (b) and CK19 (c), focally positive for CK5/6 (d) (x 10).
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On the other hand, the tumor cells of the lung tumor were negative for CK14, napsin A, and synaptophysin (Fig. 7a-f).