Patient History: A 64 year old male with a fungating mass in the lower esophagus. Slides: Click on the image to enlarge. Click on Back to return to this page
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Diagnosis: Esophagus biopsy: Papillary adenocarcinoma arising in Barrett esopahagus. Comment: This papillary lesion resembles the colonic tubulovillous adenoma with disorganized, compact glands lined by nuclei that fill the entire thickness of the epithelium, a sign of high-grade dysplasia. The complex growth pattern (back-to-back) indicates this is adenocarcinoma. The fragments of benign glandular mucosa with intestinal metaplasia are consistent with Barrett esophagus.