Unusual Symptoms

Procedure Surgical Pathology Report Esophogus September 9, 2014


Tissues:


GE Junction Bx


Clinical History:


Barrett's, see attached path (CP P-14-16763). Upper EUS/biopsy-GE junction-normal, rule out adenoma, rule out dysplasia, rule out neoplasm. Prior pathology reports for this patient were received and reviewed.



FINAL MICROSCOPIC DIAGNOSIS"


Gastroesophageal junction, biopsy:
- Adenocarcinoma in situ with at least early invasion arising in the squamocolumnar junction.
- Severely dysplastic glands extend to the deep margin focally.



Esophageal Tumor Case Summary (CAPv 2013)
Specimen(s)/procedure(s): Gastroesophageal junction, large "biopsy" (resembling an EMR)
Lesion site: Gastroesophageal junction
Lesion histologic type: Adenocarcinoma (in situ with at least early invasion)
     Lesion size: 0.32 cm greatest dimension.
     Histologic grade: G1, Well differentiated
     Microscopic tumor extension: Tumor invades at least the muscularis mucosae
Treatment effect: Treatment history not known
     Lymphovascular invasion: Not identified
Margins: Positive
     Deep margin: Involved by dysplastic glands that focally undermine the squamous mucosa.
     Mucosal/peripheral margin: Negative for carcinoma, dysplasia and intestinal metaplasia.
     Lymph node status: Concurrent mediastinal lymph node FNA (FPP-14-24258) negative for adenocarcinoma.
Distant metastasis: Not applicable

AJCC 7th ed. Pathologic Staging: At least pT1a, pNO(based on FNA of mediastinal lymph node)

Additional pathologic findings:
High grade dysplasia at the gastroesophageal junction.