Zullo Angelo, Cerro Paola, Chios Anastassios, Andriani Alessandro, Balsamo Giuseppina, Francesco Vincenzo De, Bruzzese Vincenzo
Department of Gastronterology (Angelo Zullo, Vincenzo Bruzzese), Rome, Italy.
Department of Radiology (Paola Cerro, Anastassios Chios), Rome, Italy.
Ann Gastroenterol. 2016 Jul-Sep;29(3):383-5. doi: 10.20524/aog.2016.0062. Epub 2016 Mar 3.
Dysphagia is an alarm symptom requiring a prompt investigation. Different benign and malignant diseases may present such a symptom. We describe a case of a 79-year-old patient who complained of fluctuating dysphagia episodes following solid food ingestion in the previous 5 months with mild weight loss. No other gastrointestinal symptoms were present. The patient was referred by the General Practitioner for a videofluoroscopic swallow examination which revealed nodularity of mucosa surface in the oropharynx, esophagus, fundus, and gastric body. Upper endoscopy confirmed the feature, also showing a normal mucosa of the antrum and duodenum. The histological examination revealed a mantle cell lymphoma (MCL). A stage III, MCL involving the esophagus and proximal stomach was eventually diagnosed. Esophageal MCL localization is extremely rare, and this is the first report showing a clinical onset with dysphagia.
吞咽困难是一种需要迅速进行检查的警示症状。不同的良性和恶性疾病都可能出现这种症状。我们描述了一例79岁患者的病例,该患者在过去5个月中进食固体食物后出现吞咽困难发作波动,并伴有轻度体重减轻。未出现其他胃肠道症状。该患者由全科医生转诊进行视频荧光吞咽检查,检查发现口咽、食管、胃底和胃体的黏膜表面有结节状。上消化道内镜检查证实了这一特征,同时显示胃窦和十二指肠黏膜正常。组织学检查显示为套细胞淋巴瘤(MCL)。最终诊断为累及食管和近端胃的III期MCL。食管MCL定位极为罕见,这是首例以吞咽困难为临床首发表现的报告。