Costa P M, Marques A, Oliveira E, Diaz M
Department of Surgery, Faculdade de Medicina de Lisboa and Hospital de Santa Maria, Clínica Universitária Cirurgia 3, Hospital Santa Maria, Portugal.
Dis Esophagus. 2000;13(1):75-9. doi: 10.1046/j.1442-2050.2000.00086.x.
The case of a 76-year-old woman with a submucosal tumor of the esophagus, whose principal symptoms were dysphagia and epigastric/retrosternal pain, is reported here. Endoscopy, barium swallow and a CAT scan all pointed to extramucosal localization. The lesion was located in the lower esophagus lying on the stomach fundus. An ulcer in the region of the cardia complicated the tumor. Two sets of conventional biopsies failed to detect malignancy, only inflammation and intestinal metaplasia were seen in the specimens of the mucosa surrounding the ulcer. The endoscopic ultrasonographic findings were an indistinct margin, hypoechogenicity, homogeneous appearance and location within the second and third echographic layer. The surgical resection of the tumor was complemented by an anterior partial fundoplication. The histologic study revealed an inflammatory fibroid polyp, which is a rare, benign, non-capsulated submucosal lesion composed mainly of loose connective tissue and vessels, with an eosinophilic inflammatory component. This lesion is seldom found in the esophagus.
本文报道了一例76岁女性食管黏膜下肿瘤患者，其主要症状为吞咽困难和上腹部/胸骨后疼痛。内镜检查、吞钡造影和计算机断层扫描均提示病变位于黏膜外。病变位于食管下段，紧邻胃底。贲门区域的溃疡使肿瘤情况更为复杂。两组常规活检均未发现恶性病变，仅在溃疡周围黏膜标本中可见炎症和肠化生。内镜超声检查结果显示边界不清、低回声、外观均匀且位于第二和第三超声层内。肿瘤手术切除后进行了前侧部分胃底折叠术。组织学研究显示为炎性纤维性息肉，这是一种罕见的良性非包膜性黏膜下病变，主要由疏松结缔组织和血管组成，并伴有嗜酸性炎症成分。这种病变在食管中很少见。
