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  #1  
Old 06-04-2011
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GIT Consensus: Next step in Esophageal cancer

A guy comes with progressive dyspnea, as well as dysphagia for liquids
CT was done and revealed enlarged lymph nodes around esophagus, what is the NEXT STEP?

1- EGD

2- Barium


Thats the million dollar question
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  #2  
Old 06-04-2011
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i suspect esophageal ca
so initial we do Ba study if it show narrowing of lower esophagus and irregular border then we have to confirm dx by EGD and biopsy

so the next step is Ba study
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Old 06-04-2011
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Does CT show any esophagel thickening?

Otherwise, it could well be other conditions with lymphadenopathy such as lymphoma! Extra-lumenal cause of dysphagia!
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Old 06-05-2011
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the great miss patho and amazing 1ta2b

assuming the question didnt mention anything abt esophageal thickening?


i used to think like miss patho, that barium is the best enxt step, but fischer de-emphasizes it.

what do u think 1ta2b? what is the next step in a case suggestive of cancer? and what would you do in that specific case?
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Old 06-05-2011
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well, if upper GI malignancy is suspected, endoscopy is the test of choice!
I'd go for Endoscopy!
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Old 06-05-2011
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and therein lies the rub: is next step here reflects best initial test or most accurate test ... i am lost
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Old 06-05-2011
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Endoscopy and biopsy - to get the diagnosis. So getting diagnosis is the next step!
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Old 06-05-2011
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MTB page 239
esophageal ca
best initial test is Ba study (next step)
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Old 06-05-2011
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thats the question, is next step for someone who already had a CT the same as initial? what usage would the barium give? granted, it will lay out the road map for the Dx, but didnt CT do that already?
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Old 06-24-2011
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so what final decision in this case ?

EGD OR BARIUM ?????
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