Pham Linhchi, Swanson Paul E, Tomizawa Yutaka
Department of Medicine, University of Washington, Seattle, WA.
Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA.
ACG Case Rep J. 2023 Jan 5;9(12):e00948. doi: 10.14309/crj.0000000000000948. eCollection 2022 Dec.
A 76-year-old woman was referred for 6 months of progressively worsening dysphagia and unintentional weight loss. An esophagogastroduodenoscopy demonstrated an area of extrinsic compression in the lower esophagus measuring 7 cm in greatest dimension. Contrast-enhanced computed tomography revealed a solid homogeneous mass in the lower middle/posterior mediastinum, laterally displacing the esophagus. Endoscopic ultrasound-guided fine-needle biopsy showed a hypocellular infiltrate of pleomorphic cells in a loose collagenous matrix. By immunohistochemistry, neoplastic cells were negative for epithelial, vascular, neural, and melanocytic markers. Fluorescent in situ hybridization detected amplification, compatible with a diagnosis of dedifferentiated liposarcoma.
一名76岁女性因进行性吞咽困难6个月且体重非故意减轻而前来就诊。食管胃十二指肠镜检查显示食管下段有一外在压迫区域,最大直径为7厘米。增强计算机断层扫描显示中下/后纵隔有一实性均匀肿块,使食管向外侧移位。内镜超声引导下细针穿刺活检显示在疏松的胶原基质中有多形性细胞的低细胞浸润。免疫组织化学检查显示肿瘤细胞上皮、血管、神经和黑素细胞标志物均为阴性。荧光原位杂交检测到扩增,符合去分化脂肪肉瘤的诊断。