A. Stomach Antrum Biopsy
B. Distal Esophagus Biopsy
72-year-old male admitted in March with upper GI bleeding secondary to gastric cardis ulcerations and a large duodenal ulceration in the 1st portion status post coiling of gastroduodenal aneurysm by interventional radiology. H. pylon testing negative and the patient did not admit to ASA or NSAID consumption. Examination performed to assess ulcer healing, upper GI endoscopy. Antrum-rule out H. pylori; distal esophagus-rule out dysplasia, rule out CA. Finding esophagus-mass and hiatus hernia, duodenum-ulcer.
Gastric antrum, biopsy: mild nonspecific mucosal changes (congestion); no Helicobacter pylori identified.
Distal esophagus, biopsy: severely dysplastic glands; cannot exclude adenocarcinoma.
Comment: The distal esophagus sample is fragmented and is associated with ulceration. It contains abnormal glands lined by cells showing nuclear enlargement, loss of nuclear polarity, nuclear hyperchromasia, and prominent nucleoli. In some fragments, these glands are present on both sides of muscle bundles. This finding may reflect oblique orientation of the tissue fragments, but invasive adenocarcinoma cannot be excluded.
Alcian blue-PAS stain highlights the abnormal glands.
Two parts are received in formalin labeled with the patients name and date of birth.
A. Additionally labeled "antrum" are 4 (0.2-0.9 cm in greatest dimension) tan-pink, soft fragments of tissues. The specimen is wrapped and submitted in toto in 1 cassette labeled A1.
B. Additionally labeled "distal esophagus" is a 1 x 0.3 x 0.3 cm aggregate of multiple tan-pink, soft fragments of tissue.
JD JEL 5/30/14 03:35 PM. The specimen is wrapped and submitted in toto in 1 cassette labeled B1.
| Doctor's File Notes | History | Lab Test Results |
| Medication | Symptoms | Table of Contents |