• GIST
• benign
• esophagus
• leiomyoma
• surgery
• tumor

• dysplasia
• endoscopy
• esophageal
• papillomatosis

• Esophagus
• Gastrointestinal Diseases
• METAPLASIA
• Pathology, Surgical

• EBUS
• EUS
• TBNA
• cryobiopsy
• lymph node
• mediastinal

• Efficacy and safety
• Giant esophageal leiomyoma
• Muscularis propria (MP) layer
• Piecemeal submucosal tunneling endoscopic resection (P-STER)

• Humans
• Leiomyoma/surgery
• Leiomyoma/pathology
• Female
• Middle Aged
• Esophageal Neoplasms/surgery
• Esophageal Neoplasms/pathology
• Retrospective Studies
• Male
• Endoscopic Mucosal Resection/methods
• Endoscopic Mucosal Resection/adverse effects
• Adult
• Length of Stay/statistics & numerical data
• Aged
• Esophagoscopy/methods
• Esophagoscopy/adverse effects
• Treatment Outcome
• Operative Time

• Endoscopic ultrasound (EUS)
• Epinephric diverticulum
• Esophageal leiomyoma

• Middle Aged
• Humans
• Female
• Adult
• Male
• Granular Cell Tumor/diagnostic imaging
• Magnetic Resonance Imaging/methods
• Diffusion Magnetic Resonance Imaging/methods
• Tomography, X-Ray Computed
• Head and Neck Neoplasms/diagnostic imaging
• Retrospective Studies

• Helicobacter pylori
• dysplasia
• gastric atrophy
• gastric cancer
• intestinal metaplasia
• xanthelasma

• endoscopic resection
• histological features
• hyperplastic polyp of the gastroesophageal junction
• medical management
• upper gastrointestinal bleeding

• Esophagectomy
• Esophagus
• Inflammatory pseudotumor

• Adolescent Health
• Epidemiology
• Gastroenterology

• Adult
• Humans
• Male
• Child
• Female
• Adolescent
• Retrospective Studies
• Papillomavirus Infections/diagnosis
• Papillomavirus Infections/epidemiology
• Eosinophilic Esophagitis/diagnosis
• Eosinophilic Esophagitis/epidemiology
• Eosinophilic Esophagitis/pathology
• Esophageal Neoplasms/diagnosis
• Esophageal Neoplasms/epidemiology
• Papilloma
• Carcinoma, Squamous Cell

• Endoscopic submucosal tunnel dissection (ESTD)
• Extraluminal tumors
• Submucosal tumors (SMTs)
• Submucosal tunneling endoscopic resection (STER)
• Third space endoscopy

• Bronchogenic cyst
• Endoscopic submucosal dissection
• Endoscopic ultrasonography
• Esophagus
• Submucosal tunneling endoscopic rection

• Esophageal granulosa cell tumors
• endoscopic resection
• endoscopic ultrasonography
• esophageal submucosal tumors

Esophageal carcinosarcoma (ECS) is a rare biphasic tumor and a type of esophageal malignancy, which presents as protruding or elevated lesions. ECS patients are often not hospitalized until they have severe dysphagia. ECS is easily misdiagnosed as a benign tumor due to its atypical characteristics under endoscopy. With the popularization of endoscopic treatment, these patients are often referred to endoscopic treatment, such as endoscopic submucosal dissection (ESD). However, there is a lack of consensus on the endoscopic features and therapies for ECS. Here, we report a case of ECS and discuss the value of endoscopic diagnosis and therapeutic strategies.

A 63-year-old man was admitted to the hospital with dysphagia. During the endoscopic examination, an elevated lesion was found with an erosive and hyperemic surface covered with white pseudomembranous inflammation. Endoscopic ultrasonography (EUS), biopsies, and enhanced thoracic computed tomography were performed, suggesting that it was a benign lesion and located within the submucosal layer. This lesion was diagnosed as a fibrovascular polyp with a Paris classification of 0-Ip. The patient was then referred to ESD treatment. However, the post-ESD pathological and immunohistochemical study showed that this lesion was ECS with a vertical positive margin (T1b stage), indicating that we made a misdiagnosis and achieved a noncurative resection. Due to the potential tumor residue, additional open surgery was performed at the patient's request. In the postoperative pathological study, no tumor remnants or metastases were discovered. The patient was followed for 1 year and had no recurrence.

ECS can be misdiagnosed at the initial endoscopy. EUS can help to identify the tumor stage. Patients with T1b stage ECS cannot be routinely referred to ESD treatment due to the high risk of metastasis and recurrence rate.

• Esophageal carcinosarcoma
• Misdiagnosis
• Endoscopic ultrasonography
• Endoscopic submucosal dissection
• T1 stage
• Case report

A granular cell tumor (GCT) is an unusual benign soft tissue tumor that can occur at any age and in any part of the body. GCTs are mostly found in the skin and subcutaneous tissues, bronchi, esophagus, breast tissue, and tongue. A GCT originating in the digestive tract, particularly in the appendix, is relatively rare and usually diagnosed as an incidental finding. We herein describe the first case of abdominal distension and occasional pain secondary to a GCT of the appendix in our hospital. The findings from this case suggest that a GCT of the appendix is a rare entity for which surgical resection is an efficient therapy.

• Granular cell tumor
• case report
• ileocecal appendix
• laparoscopic appendectomy
• oncologic management
• therapy

• endoscopic treatment
• esophageal leiomyoma
• non-epithelial tumor
• submucosal neoplasms of the esophagus
• tunnel dissection

• Endoscopic Mucosal Resection/adverse effects
• Endoscopic Mucosal Resection/methods
• Esophageal Neoplasms/diagnosis
• Esophageal Neoplasms/pathology
• Esophageal Neoplasms/surgery
• Humans
• Leiomyoma/complications
• Leiomyoma/diagnosis
• Leiomyoma/surgery
• Retrospective Studies
• Treatment Outcome

The association of eosinophilic esophagitis and esophageal polyps has been reported in the literature but remains a rare finding in both adults and children. The patient in this case report presented with progressively worsening dysphagia secondary to eosinophilic esophagitis and an esophageal polyp. Dysphagia is always abnormal, and endoscopic evaluation is essential. Dysphagia is a well-known symptom in patients with eosinophilic esophagitis. While esophageal polyps as a whole are less common in the pediatric population, they should not be overlooked as a possible cause of dysphagia and esophageal obstruction.

• Deglutition
• Deglutition disorders
• Dysphagia aortica
• Esophageal dysphagia
• Videofluoroscopy

• Adult
• Carcinoma, Squamous Cell/epidemiology
• Female
• Gastroesophageal Reflux/epidemiology
• Humans
• Papilloma
• Retrospective Studies
• Turkey/epidemiology

Gastrointestinal xanthomas are asymptomatic and infrequent non-neoplastic lesions that commonly occur in the stomach with Helicobacter pylori-associated gastritis and rarely in the esophagus. To date, there have been no reports of esophageal xanthoma combined with esophageal cancer. Herein, we present the first case in the literature of a diffuse xanthoma complicated with early esophageal cancer. Moreover, this combination makes the endoscopic diagnosis difficult if it is not in mind.

A 68-year-old man visited our department with a 2-mo history of epigastric discomfort. He underwent surgery for gastric cancer 6 years ago. Esophagogastroduodenoscopy showed a semi-circumferential irregular yellowish-colored and granular lesion in the esophagus (30-35 cm from the incisors). Using magnifying endoscopy with narrow band imaging, aggregated minute and yellowish-colored spots with tortuous microvessels on the surface were observed, and background coloration was clearly seen in the lesion. As endoscopic biopsy suggested a histologically high-grade dysplasia; the lesion was completely resected en bloc by endoscopic submucosal dissection (ESD). The resected specimen was confirmed to be a squamous cell carcinoma in situ with extensive foamy cells in the superficial mucosal layer. Immunohistochemically, the observed foamy cells were strongly positive for CD68, which is characteristic of xanthoma. The clinical course was favorable, and no recurrence was observed 2 years and 7 mo after ESD.

Diffuse xanthoma concurrent with early esophageal cancer is extremely rare. The characteristic endoscopic features may assist endoscopists in diagnosing similar lesions.

• Esophageal xanthoma
• Early esophageal cancer
• Magnifying endoscopy
• Endoscopic submucosal dissection
• Case report

• Endoscopy
• Esophagitis
• Esophagus
• Gastroesophageal reflux disease
• Granular cell tumor

Hyperplastic polyp of the esophagus is a rare condition and most of the time asymptomatic. We report a case of a 69-year-old female with scleroderma who presented with worsening dysphagia, regurgitation of food, and non-cardiac chest pain. Upper endoscopy showed a nodular lesion in the distal esophagus. Biopsy of the lesion showed features of hyperplastic polyp without any metaplastic changes. She was started on anti-acid therapy and an outpatient upper endoscopy was performed which showed no residual polyp.

• dysphagia
• esophagus
• heartburn
• polyp
• scleroderma

In our study, we aimed to evaluate the endoscopic features such as prevalence and localization of polypoid lesions determined by us using esophagogastroduodenoscopy and histopathological characteristics of biopsy specimens taken in detail.

The data of 19,560 patients undergoing upper gastrointestinal endoscopy for any reason between 2009 and 2015 in our endoscopy unit were screened retrospectively and endoscopic and histopathological findings were analyzed in detail.

In our study, the polypoid lesion was detected in 1.60% (n=313) of 19,560 patients. The most common localization of the polypoid lesions was determined to be gastric localization (n=301, 96.2%) and antrum with a rate of 33.5% (n=105). When 272 patients in whom biopsy specimen could be taken was investigated, the most frequently seen lesion was polyp (n=115, 43.4%). Hyperplastic polyps (n=81, 29.8%) were the most frequently seen type among all polyps. In histopathological evaluation of the lesions, the prevalence rates of intestinal metaplasia (IM), surrounding tissue IM, atrophy, dysplasia, and neoplasia (adenocarcinoma, squamous cell carcinoma, gastrointestinal stromal tumor, neuroendocrine tumor, and metastatic tumor) among premalignant lesions were determined to be 16.9%, 11.2%, 4.1%, 1.1%, and 3.7%, respectively.

Polypoid lesions can be seen in endoscopic investigations. In histopathological investigations, while the vast majority of these lesions are benign polyps, some of them are diagnosed as premalignant or malignant lesions. In our study, we determined malignant lesions higher than the similar studies in the literature. This condition shows how effective endoscopic procedure and histopathological evaluation are of vital importance.

• Endoscopy
• histopathology
• polypoid lesion

• Esophageal cancer
• Gastric cancer
• Magnetic resonance imaging
• Prognosis
• Staging
• Treatment response

• Biomarkers/analysis
• Contrast Media
• Diagnosis, Differential
• Esophageal Diseases/diagnostic imaging
• Humans
• Image Enhancement/methods
• Image Interpretation, Computer-Assisted/methods
• Magnetic Resonance Imaging/methods
• Prognosis
• Stomach Diseases/diagnostic imaging

• Comedones
• Ectopic sebaceous glands
• Endoscopic sign
• Esophagogastroduodenoscopy
• Esophagus
• Fordyce spots

• endoscopic submucosal dissection
• esophageal neoplasms
• mucosa-associated lymphoid tissue (MALT) lymphoma
• non-Hodgkin lymphoma

• Aged
• Biopsy
• Endoscopic Mucosal Resection
• Esophageal Neoplasms/pathology
• Esophageal Neoplasms/surgery
• Female
• Humans
• Lymphoma, B-Cell, Marginal Zone/pathology
• Lymphoma, B-Cell, Marginal Zone/surgery

• endoscopic ultrasonography
• esophageal neoplasms
• granular cell tumor
• leiomyoma
• subepithelial tumor

• Adult
• Diagnosis, Differential
• Endosonography/methods
• Esophageal Neoplasms/diagnostic imaging
• Esophageal Neoplasms/pathology
• Esophagoscopy
• Female
• Granular Cell Tumor/diagnostic imaging
• Granular Cell Tumor/pathology
• Humans
• Leiomyoma/diagnostic imaging
• Male
• Middle Aged
• Retrospective Studies
• Ultrasonography/methods

We describe two cases of leiomyoma in the colon that were diagnosed histologically after endoscopic resection. The first case was a 79-year-old Japanese woman who presented with a pedunculated polyp of 14 mm length at the splenic flexure. Preoperative diagnosis suggested a colonic mucosubmucosal elongated polyp. The second case was a 29-year-old Japanese woman who presented with a pedunculated polyp of 40 mm length at the hepatic flexure and had an ulcer on top of the polyp. Preoperative diagnosis suggested an inflammatory fibroid polyp. A pathological diagnosis of colonic leiomyoma was made after endoscopic resection in both cases. Both tumors were confirmed to originate, not from the proper muscle layer, but from the muscularis mucosae. These cases underscore that although colonic involvement is infrequent, leiomyomas can display pedunculated morphology in the colon rather than the typical gross appearance of gastrointestinal submucosal tumors seen with sessile morphology.

• Esophageal Neoplasms
• Humans
• Leiomyoma

We present two cases of esophageal papillomatosis, a very rare reported disease leading to dysphagia and did not improve after endoscopic treatment. Both patients refused surgery and they were followed-up for 3 years, but no significant clinical or endoscopic changes were seen.

Xanthomas are localized nonneoplastic lesions within tissues that may manifest as papules, plaques, or nodules. These lesions can be found anywhere along the gastrointestinal tract, commonly in the stomach and colon, and rarely in the small intestine and esophagus. Esophagogastroduodenoscopy (EGD) with biopsy is the gold standard tool for diagnosis. Here, we report a rare case of a lower solitary nodular esophageal xanthoma in an elderly black female. Correspondingly, all cases of esophageal xanthomas reported in the English medical literature were reviewed and presented with the reported case.

Non-malignant oesophageal diseases are critical to recognize, but can be easily overlooked or misdiagnosed radiologically. In this paper, we cover the salient clinical features and imaging findings of non-malignant pathology of the oesophagus. We organize the many non-malignant diseases of the oesophagus into two major categories: luminal disorders and wall disorders. Luminal disorders include dilatation/narrowing (e.g. achalasia, scleroderma, and stricture) and foreign body impaction. Wall disorders include wall thickening (e.g. oesophagitis, benign neoplasms, oesophageal varices, and intramural hematoma), wall thinning/outpouching (e.g. epiphrenic diverticulum, Zenker diverticulum, and Killian-Jamieson diverticulum), wall rupture (e.g. iatrogenic perforation, Boerhaave Syndrome, and Mallory-Weiss Syndrome), and fistula formation (e.g. pericardioesophageal fistula, tracheoesophageal fistula, and aortoesophageal fistula). It is the role of the radiologist to recognize the classic imaging patterns of these non-malignant oesophageal diseases to facilitate the delivery of appropriate and prompt medical treatment.

• Nonmalignant oesophageal disease can be categorised by the imaging appearance of wall and lumen.

• Scleroderma and achalasia both cause lumen dilatation via different pathophysiologic pathways.

• Oesophageal wall thickening can be inflammatory, neoplastic, traumatic, or vascular in aetiology.

• Dilatation
• Non-malignant
• Oesophagus
• Rupture
• Stricture

• Mesenchymal gastrointestinal neoplasm
• cell-block procedure
• differential diagnosis
• immunohistochemistry

• Endoscopy
• esophagus
• gastroesophageal reflux
• heterotopic sebaceous glands

Background. Ultrasound (US) is the most accurate tool in the diagnosis of thyroid nodules if performed by expert physician. Misdiagnosis due to extrathyroidal lesions mimicking thyroid nodules is reported in literature. We describe the first case of an esophageal fibrovascular polyp misdiagnosed as a thyroid nodule on US examination. Patient Findings. A 54-year-old woman presented to emergency department for headache and underwent carotid Doppler extended to neck ultrasound with incidental finding of a nodule in the posterior side of the left thyroid lobe. A following thyroid US performed by an endocrinologist allowed the characterization of the lesion as an esophageal pathology, considering the extrathyroidal position, the typical peripheral hyperechoic spots and hypoechoic rim, the connection to the esophagus, and the swallowing connected movement. The patient was addressed to further investigations and finally to anterior pharyngotomy with histological diagnosis of esophageal fibrovascular polyp. Summary. Differential diagnosis between thyroid nodules and other neck lesions is important to prevent an unnecessary fine needle aspiration biopsy and to treat the extrathyroidal pathology. In this case, an US performed by an expert endocrinologist allowed detecting an esophageal fibrovascular polyp requiring surgical removal. In conclusion, the possibility of an esophageal pathology, and even fibrovascular polyp, should be considered during US thyroid examination.

AIM: To better understand some of the superficial tiny lesions that are recognized as squamous papilloma of the esophagus (SPE) and receive a different pathological diagnosis.

METHODS: All consecutive patients with esophageal polypoid lesions detected by routine endoscopy at our Endoscopy Centre between October 2009 and June 2014 were retrospectively analysed. We enrolled patients with SPE or other superficial lesions to investigate four key endoscopic appearances (whitish color, exophytic growth, wart-like shape, and surface vessels) and used narrow band imaging (NBI) to distinguish their differences. These series endoscopic images of each patient were retrospectively reviewed by three experienced endoscopists with no prior access to the images. All lesion specimens obtained by forceps biopsy were fixed in formalin and processed for pathological examination. The following data were collected from patient medical records: gender, age, indications for esophagogastroduodenoscopy, and endoscopic characteristics including lesion location, number, color, size, surface morphology, surrounding mucosa, and surface vessels under NBI. Clinicopathological features were also compared.

RESULTS: During the study period, 41 esophageal polypoid lesions from 5698 endoscopic examinations were identified retrospectively. These included 24 patients with pathologically confirmed SPE, 11 patients with squamous hyperplasia, three patients with glycogenic acanthosis, two patients with ectopic sebaceous glands, and one patient with a xanthoma. In the χ² test, exophytic growth (P = 0.003), a wart-like shape (P < 0.001), and crossing surface vessels under NBI (P = 0.001) were more frequently observed in SPE than in other lesion types. By contrast, there was no significant difference regarding the appearance of a whitish color between SPE and other lesion types (P = 0.872). The most sensitive characteristic was wart-like projections (81.3%) and the most specific was exophytic growth (87.5%). Promising positive predictive values of 84.2%, 80.8%, and 82.6% were noted for exophytic growth, wart-like projections, and surface vessel crossing on NBI, respectively.

CONCLUSION: The use of three key typical endoscopic appearances - exophytic growth, a wart-like shape, and vessel crossing on the lesion surface under NBI - has a promising positive predictive value of 88.2%. This diagnostic triad is useful for the endoscopic diagnosis of SPE.

• Diagnosis
• Endoscopy
• Esophagus
• Squamous papilloma
• Narrow band imaging

• Adult
• Aged
• Biopsy
• Chi-Square Distribution
• Diagnosis, Differential
• Esophageal Neoplasms/diagnostic imaging
• Esophageal Neoplasms/pathology
• Esophagoscopy/methods
• Female
• Humans
• Male
• Middle Aged
• Narrow Band Imaging
• Papilloma/diagnostic imaging
• Papilloma/pathology
• Polyps/diagnostic imaging
• Polyps/pathology
• Predictive Value of Tests
• Reproducibility of Results
• Retrospective Studies
• Taiwan

The widespread popularity of new surgical technologies such as laparoscopy, thoracoscopy and robotics has led many surgeons to treat esophageal diseases with these methods. The expected benefits of minimally invasive surgery (MIS) mainly include reductions of postoperative complications, length of hospital stay, and pain and better cosmetic results. All of these benefits could potentially be of great interest when dealing with the esophagus due to the potentially severe complications that can occur after conventional surgery. Moreover, robotic platforms are expected to reduce many of the difficulties encountered during advanced laparoscopic and thoracoscopic procedures such as anastomotic reconstructions, accurate lymphadenectomies, and vascular sutures. Almost all esophageal diseases are approachable in a minimally invasive way, including diverticula, gastro-esophageal reflux disease, achalasia, perforations and cancer. Nevertheless, while the limits of MIS for benign esophageal diseases are mainly technical issues and costs, oncologic outcomes remain the cornerstone of any procedure to cure malignancies, for which the long-term results are critical. Furthermore, many of the minimally invasive esophageal operations should be compared to pharmacologic interventions and advanced pure endoscopic procedures; such a comparison requires a difficult literature analysis and leads to some confounding results of clinical trials. This review aims to examine the evidence for the use of MIS in both malignancies and more common benign disease of the esophagus, with a particular emphasis on future developments and ongoing areas of research.

• Esophageal disease
• Esophageal cancer
• Laparoscopic
• Robotic
• da Vinci
• Heller
• Reflux disease
• Esophageal diverticula

• Adolescent
• Endoscopy, Digestive System
• Esophageal Diseases/diagnosis
• Esophageal Diseases/pathology
• Esophagus/pathology
• Female
• Humans
• Male
• Polyps/diagnosis
• Polyps/pathology
• Stomach/pathology
• Stomach Diseases/diagnosis
• Stomach Diseases/pathology