A 43-year-old male was admitted to the Phillips House for treatment of a tumor of the esophagus. Thirteen months prior to admission he began to have difficulty swallowing, which he described as a sensation of food being delayed as it passed through the esophagus. One year before entry he had noted the onset of vague, intermittent substernal pain. It was about this time that he had the barium study of the esophagus you see here ( Fig. 1 and 2). His appetite had been good, but when he was told that he had a tumor, it became poor, and he lost 5 lb. in weight.His history, physical examination, and laboratory studies were noncontributory, We have no interpretation of these films, as this examination was performed at another hospital.Dr. Joseph Hanelin: This reminds me of a patient that I thought had calcified mediastinal lymph nodes; what I thought were tuberculous lymph nodes turned out to be a leiomyoma in that area. I should wonder about this also being a leiomyoma.Dr. Laurence L. Robbins: You don't think these could be tuberculous nodes?Dr. Hanelin: I suppose that these could be.That's what I thought the last time. Under ordinary circumstances, I should perhaps have thought of this first.Dr. Stanley M. Wyman: I should agree with Dr.
Dr. William T. McCoy: A 31-year-old man was well until July of 1960, when he noted the onset of epigastric pain and nausea. On one occasion he vomited about a cupful of bright red blood. He was seen by his local physician and an upper gastrointestinal series was performed, and a duodenal ulcer diagnosed. He was treated for this, and remained much improved until some time later when amoebic enteritis was diagnosed and subsequently treated. In October the man again vomited blood, and an upper gastrointestinal series was performed Fig. 1.-Spot film; question of varices.Fig. 2.-Upper gastrointestinal x-ray. From the Weekly X-ray Seminar, Department of Radiology, Massachusetts General Hospital. Downloaded From: http://jama.jamanetwork.com/ by a University of Manitoba User on 06/09/2015
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