Linitis-like squamous esophageal cancer diagnosed by endoscopic ultrasonography-guided fine-needle aspiration cytology

Adrián–de–Ganzo, Zaida; Gimeno–García, Antonio Z.; Elwassief, Ahmed; Paquin, Sarto C.; Sahai, Anand V.; García-Castro, Candelaria; Nicolás–Pérez, David; Brito-García, Alejandro; Martín-Corriente, María del Carmen; Gariépy, Gilles; Quintero, Enrique

doi:10.1097/meg.0b013e3283643dfb

Cited by 4 publications

(11 citation statements)

References 7 publications

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“…Considering the current advances in the management of esophageal malignancy, histopathological diagnosis is an earnest requirement. There is only one reported series of two cases in which patients underwent linear EUS and FNAC for esophageal strictures, but the EUS was performed after stricture dilatation . There is one study that described a large number ( n = 23) of patients with esophageal or gastroesophageal junction malignancy, but all patients in this series presented with submucosal lesions, which were confirmed on EUS and EUS‐guided FNAC .…”

Section: Discussionmentioning

confidence: 90%

“…Smooth esophageal strictures, as in our series, are not a rare clinical problem. Apart from smooth strictures, verrucous variety, submucosal presentation of SCC, and secondary metastatic esophageal stricture may also produce biopsy negative results …”

Section: Discussionmentioning

confidence: 99%

“…Apart from smooth strictures, verrucous variety, submucosal presentation of SCC, and secondary metastatic esophageal stricture may also produce biopsy negative results. 7,[10][11][12][13][14] EUS has a well-established role in the staging of esophageal cancer, but the role of EUS in its diagnosis is not well studied. 1 The earliest report in biopsy-negative malignant stricture is of radial EUS, and visual appearance was taken as the diagnostic criterion for malignancy, which was later confirmed on postoperative histopathological specimens.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 The yield of biopsies post dilation and post ultrathin endoscopy is also limited. 3,7 Nonetheless, definitive diagnosis is essential for the management of these patients, especially in view of advances in chemoradiotherapy. 8,9 Few case reports and small case series have shown the role of EUS with or without fineneedle aspiration cytology (FNAC) in such patients.…”

Section: Introductionmentioning

confidence: 99%

“…8,9 Few case reports and small case series have shown the role of EUS with or without fineneedle aspiration cytology (FNAC) in such patients. 3,7,10 Here, we present our experience on the role of linear EUS in diagnosing esophageal cancer presenting as a smooth stricture.…”

Section: Introductionmentioning

confidence: 99%

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Role of linear endosonography in the diagnosis of biopsy‐negative malignant esophageal strictures: Exploring the unexplored

et al. 2019

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Background and Aim Endoscopic biopsy is standard for the diagnosis of esophageal malignancy. However, few cases present with smooth stricture with repetitive negative biopsy results. We aimed to use linear endoscopic ultrasound (EUS) and fine‐needle aspiration (FNA) in the diagnosis of biopsy‐negative suspected malignant esophageal strictures. Methods We retrospectively analyzed the data from August 2017 to December 2018 of biopsy‐negative esophageal strictures. All adult patients with twice‐negative biopsies and with smooth overlying esophageal mucosa on endoscopy were included. Clinical, epidemiological, endoscopic, imaging, and EUS findings were noted and analyzed. Results Eighteen patients underwent EUS for suspicion of malignant esophageal stricture. Seven were excluded as they were submucosal tumors. Eleven patients showed the presence of malignancy on EUS FNA samples. Nine were males. Computed tomography showed esophageal wall thickening in eight (16–38 mm) and esophageal mass in three patients. EUS showed loss of a normal five‐layered wall structure of the esophagus in all patients. Fine‐needle aspiration cytology demonstrated squamous cell carcinoma (n = 4), adenocarcinoma (n = 4), poorly differentiated carcinoma (n = 2), and neuroendocrine carcinoma (n = 1). There were no complications. Conclusion EUS with FNA is effective and safe for the diagnosis of biopsy‐negative malignant esophageal strictures.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Role of linear endosonography in the diagnosis of biopsy‐negative malignant esophageal strictures: Exploring the unexplored

et al. 2019

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Verrucous esophageal carcinoma is a unique indolent subtype of squamous cell carcinoma: a systematic review and individual patient regression analysis

Haffar²,

Horibe

et al. 2020

J Gastroenterol

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Endoscopic ultrasound-guided fine needle aspiration for smooth benign appearing malignant esophageal stricture: a cross-sectional study

Cao¹,

Chen²,

Su³

et al. 2022

J Thorac Dis

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Background: Endoscopic biopsy is standard for the diagnosis of esophageal malignancy. However, few cases are difficult to diagnose as they present with smooth esophageal stricture with negative biopsy results.We aimed to evaluate the effectiveness and safety of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in the diagnosis of biopsy-negative suspected malignant esophageal strictures. Methods:We retrospectively analyzed cases of esophageal stricture with negative biopsies. From September 2016 to November 2021, 50 patients were enrolled. All the patients accepted the EUS-FNA examination.And histological and cytological specimens were obtained from all patients. Clinical, endoscopic, imaging, cytological, and histopathological results were noted and analyzed.Results: A total of 50 patients (40 male and 10 female) were enrolled in this study. The 19G puncture needle was used in 6 cases and the 22G puncture needle was used in 44 cases; an average of 2.7 needles were used per case. Satisfactory specimens were obtained by EUS-FNA for all subjects. All patients were diagnosed as malignant tumor. The diagnosis was confirmed by EUS-FNA biopsies in 98% of patients. Based on the surgical pathology results, there were 16 cases of esophageal squamous cell carcinoma, 2 cases of esophageal metastatic carcinoma, 1 case of esophageal sarcoma, 22 cases of lung cancer, 6 cases of mediastinal lymph node metastasis, and 3 cases of mediastinal tumor. No obvious complications were observed. A total of 5 cases were treated with surgery, 28 with chemotherapy, 3 with chemotherapy + surgery, and 12 with radiotherapy; 2 patients ceased treatment. No obvious complications, such as bleeding and mediastinal infection, were observed.Conclusions: EUS-FNA is effective and safe for the diagnosis of malignant esophageal strictures with smooth overlying esophageal mucosa. EUS-FNA is effective and safe for patients with smooth esophagus stenosis for whom satisfactory cytological and histological specimens can be obtained, and the diagnosis can be confirmed by cytological, histological, and immunohistochemical examinations. It can be used as the first choice for diagnosis and treatment.

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Linitis-like squamous esophageal cancer diagnosed by endoscopic ultrasonography-guided fine-needle aspiration cytology

Cited by 4 publications

References 7 publications

Role of linear endosonography in the diagnosis of biopsy‐negative malignant esophageal strictures: Exploring the unexplored

Role of linear endosonography in the diagnosis of biopsy‐negative malignant esophageal strictures: Exploring the unexplored

Verrucous esophageal carcinoma is a unique indolent subtype of squamous cell carcinoma: a systematic review and individual patient regression analysis

Endoscopic ultrasound-guided fine needle aspiration for smooth benign appearing malignant esophageal stricture: a cross-sectional study

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