Kubota Yo, Tanabe Satoshi, Harada Yohei, Nakatani Seigo, Furue Yasuaki, Wada Takuya, Watanabe Akinori, Ishido Kenji, Katada Chikatoshi, Koizumi Wasaburo
Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan.
Department of Advanced Medicine Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Sagamihara, Japan.
Case Rep Gastroenterol. 2020 Oct 22;14(3):510-515. doi: 10.1159/000508861. eCollection 2020 Sep-Dec.
The diagnosis of Barrett's esophageal adenocarcinoma (BEA) in patients with Barrett's esophagus (BE) using endoscopy can be difficult and there are few specific endoscopic findings for BEA. However, white globe appearance (WGA) has been reported to be a specific endoscopic finding for early gastric cancer. We encountered a 51-year-old male patient with BEA exhibiting WGA. Esophagogastroduodenoscopy identified a red, depressed lesion of 10 mm within the long-segment BE (LSBE), while magnifying endoscopy with narrow-band imaging identified WGA. Endoscopic submucosal dissection (ESD) was performed based on our suspicion of BEA. Based on the ESD findings, we diagnosed adenocarcinoma accompanying LSBE histopathologically. WGA was identified, and intraglandular necrotic debris was discovered histologically at the same site. Therefore, WGA may be helpful in the diagnosis of BEA.
在内镜检查中，巴雷特食管（BE）患者的巴雷特食管腺癌（BEA）诊断可能具有挑战性，且BEA几乎没有特异性的内镜表现。然而，白球状外观（WGA）已被报道为早期胃癌的一种特异性内镜表现。我们遇到了一名51岁的男性BEA患者，其呈现出WGA。食管胃十二指肠镜检查在长段BE（LSBE）内发现了一个10毫米的红色凹陷性病变，而窄带成像放大内镜检查发现了WGA。基于我们对BEA的怀疑，进行了内镜黏膜下剥离术（ESD）。根据ESD结果，我们在组织病理学上诊断为伴有LSBE的腺癌。发现了WGA，并且在同一部位组织学上发现了腺体内坏死碎片。因此，WGA可能有助于BEA的诊断。
