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  #1  
Old 02-19-2011
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GIT Esophageal Neoplasm Question

An esophageal biopsy sample taken from a 53-year-old Caucasian male with dysphagia is shown on the slide below. You should inform the patient that he most likely suffers from which of the following?

Esophageal Neoplasm Question-eso-biopsy.jpg
click image to enlarge


A. Motor dysfunction with some risk of carcinoma
B. Reflux esophagitis with high risk of dysplasia
C. Dysplasia with high risk of adenocarcinoma
D. Benign tumor with slow growth
E. Malignancy with probable poor prognosis
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  #2  
Old 02-19-2011
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Default C

i will go with C.but m not sure
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Old 02-19-2011
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I see a keratin pearl...
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E...confused
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a perhaps?
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...and possibly some mitotic figures
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Default E

I think the diagnosis could be squamous cell carcinoma (hint: keratin pearl), which is malignancy of esophagus with poor prognosis
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E
Can see keratin pearl= squamous cell carcinoma= bad prognosis.
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E- Squamous carcinoma
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Let us approach this Q.

Pic is classic for keratin pearl. Hence there is no doubt that it is squamous carcinoma.

E!! but adenocarcinoma also carries poor prognosis.....

A! yes, achalasia, a motor disorder, carries a small risk for squamous carcinoma. Big risks are smoking and alcohol.

B and C go with adeno, D doesn't apply here.

I would go with A, because E refers to both adeno and squamous.

Sorry! the correct answer is E! the wording of the Q stem asks for what he is suffering from?
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Arrow E) Malignancy with probable poor prognosis

The correct ans is E) Malignancy with probable poor prognosis

mle2resident, Mondoshawan, drahmednawaz and doctorsmonsters are correct!

Esophageal Neoplasm Question-keratinpearl.jpg
click image to enlarge

This is a typical image of squamous cell carcinoma on high power. Squamous cell carcinomas consist of solid nests of neoplastic squamous cells with abundant eosinophilic cytoplasm and distinct borders. Areas of keratinization (keratin pearls) are easily noticed, as in this picture. Keratin pearls are a sign that the tumor hasn’t yet lost the properties of an original tissue—in other words, it is a well-differentiated tumor. In poorly-differentiated squamous cell carcinoma, there is usually no keratinization, cells vary in size and shape, and cells have large darkly-staining nuclei. Numerous mitotic figures might be seen.

Squamous cell carcinoma comprises 500k of esophageal cancers in United States. The most important risk factors are alcohol and tobacco use. Plummer-Vinson syndrome achalasia and corrosive strictures of esophagus are other risk factors

Most squamous cell carcinomas of the esophagus occur in male patients older than 50 years old. Presentation includes progressive dysphagia, first for solids, then for both solids and liquids. Significant weight loss is common.
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Gastrointestinal-Tract-, Micrographs-, Pathology-, Step-1-Questions

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