A case of esophageal barrett’s adenocarcinoma forming a longitudinal elevation

症例は60歳代の男性.近医での上部消化管内視鏡検査で食道に隆起性病変を指摘され,精査加療目的で当科に入院した.上部消化管内視鏡検査で胸部上部食道から食道胃接合部にかけて縦走する隆起性病変を認め,下部食道ではBarrett食道を認めた.隆起部の生検で腺癌と診断された.食道造影検査では,胸部下部食道で壁変形が強く台状変形を認めた.造影CT等で気管分岐部,噴門部,右半回リンパ節転移が疑われたが,遠隔転移は否定的であった.胸腔鏡・腹腔鏡補助下食道亜全摘術を施行し,病理診断は中分化型腺癌で外膜浸潤を認め,癌の脈管侵襲が目立った.内視鏡的･病理学的にBarrett食道が認められ,Barrett食道由来の腺癌の可能性が考えられた.本病巣は著明な脈管侵襲により縦走する形態を呈したと考えられた.

A-60-year-old man was referred to our hospital for further examination and treatment for a longitudinal elevation from the upper to lower esophagus and a short segment Barrett’s esophagus in the esophagogastric junction. Histlogical examination of the biopsy specimen from the elevated lesion showed adenocarcinoma. Upper gastrointestinal series showed the same findings as EGD, and trapezoid deformity in the lower esophagus. Sub-total esophagectomy was performed. Histopathological examination revealed Barrett’s esophagus and adenocarcinoma with massive lymphovascular invasion. Based on these findings, we thought that this tumor was esophageal adenocarcinoma arising from Barrett’s esophagus and forming a longitudinal elevation.

食道腺癌

Barrett食道

脈管侵襲