11. 5815
 

 
M   60
 

 
Clinical  diagnosis:  GERD ,   rule out  carcinoma.
 
Received:  a  single   biopsy   said   to  be   from  an  ulcer    in  the   distal   esophagus.
 

 
Problem:  in my  opinion   this  is  not  a  typical Barrett  lesion.  There   are  few   non-neoplastic  foveolar  glands  at  one   rim    of   the    biopsy.  The  main  feature  are      glands   immediately  beneath  the     squamous   epithelium   which   I  consider  to   be  malignant.  Is  this  an  adenocarcinoma   arising  from      esophageal   glands?  Thanks !

kunze 2011-12-18 16:23	There are no morphological hints at a chondroid bone lesion. I share your impression of a reactive callus-like bone formation
kunze 2011-12-18 16:36	Please, forget my first comment!   I support your diagnosis of a well differentiated adenocarcinoma with a probable origin from esophageal glands. Anyway, the typical histology of a Barrett-mucosa is not visible in the submitted images.
tornillo 2011-12-22 10:59	I think this is a well-differentiated adenocarcinoma of the esophagus, which grows in the submucosa under the squamous epithelium. There is no recognizable Barrett's mucosa. It could be an adenocarcinoma of the esophageal glands, though the localisation is not typical, but a Barrett's carcinoma cannot be excluded simply on these biopsies, becase there is always the possibility of an insufficient sampling. A definitive statement could be made only on the resection