摘要
Abstract
Esophageal submucosal gland duct adenoma(ESGDA)is a rare benign tumor originating from the submucosal gland(SMG)of the esophagus,most commonly occurring in the lower esophagus.Due to the dense arrangement of irregular glands and reduced stromal appearance in small biopsy specimens,along with necrotic cellular debris and inflammatory exudate within the lumina,ESGDA can be easily misdiagnosed as adenocarcinoma.This paper reports a case of ESGDA located in the upper esophagus in a 64-year-old female who was previously misdiagnosed with esophageal adenocarcinoma at another hospital.The patient presented with retrosternal discomfort for several months.Ultrasonography revealed a mucosal lesion with hyperechoic characteristics.Endoscopy showed a 0.4 cm×0.4 cm flat mucosal elevation at 23 cm from the incisor line,which was treated with endoscopic mucosal resection.Histologically,the lesion exhibited irregular glandular structures containing eosinophilic secretions,composed of a bilayered epithelium with monolayer or multilayer cell arrangement and bland cytologic features.Immunohistochemically,tumor cells were positive for cytokeratin(CK)5/6,CK7,CK8/18,P40,and P63,indicating both glandular epithelium and myoepithelial differentiation.There was no desmoplastic stromal reaction suggestive of malignancy,though sparse lymphocytic and eosinophilic infiltrates were present.Diagnosis of ESGDA requires careful evaluation of epithelial composition,cytologic features,and stromal context,with immunohistochemical staining aiding in determining differentiation,in order to avoid misdiagnosis and unnecessary surgical intervention.关键词
食管上段/食管黏膜下腺导管腺瘤/食管腺癌/细胞角蛋白/免疫组织化学染色Key words
upper esophagus/esophageal submucosal gland duct adenoma/esophageal adenocarcinoma/cytokeratin/immunohistochemistry
