Rare Primary Esophageal Paget’s Disease Diagnosed on a Large Bloc Specimen Obtained by Endoscopic Mucosal Resection

Authors

  • Hirohito Mori Department of Gastroenterology and Neurology, Kagawa University, Kagawa, Japan
  • Maki Ayaki Department of Gastroenterology and Neurology, Kagawa University, Kagawa, Japan
  • Hideki Kobara Department of Gastroenterology and Neurology, Kagawa University, Kagawa, Japan
  • Yasuhiro Goda Department of Gastroenterology and Neurology, Kagawa University, Kagawa, Japan
  • Noriko Nishiyama Department of Gastroenterology and Neurology, Kagawa University, Kagawa, Japan
  • Tsutomu Masaki Department of Gastroenterology and Neurology, Kagawa University, Kagawa, Japan

DOI:

https://doi.org/10.15403/jgld.2014.1121.264.pag

Keywords:

Primary Paget’s disease, large bloc specimen, endoscopic mucosal resection

Abstract

Primary esophageal Paget’s disease is rare. Only a few case reports have described the intraepithelial papillary capillary loop (IPCL) pattern obtained by magnified Narrow Band Imaging (M-NBI) endoscopy in this rare pathology. This report highlights the usefulness of M-NBI and the successful diagnosis using a large bloc specimen obtained by endoscopic mucosal resection with the cap method (EMR−c). A 53-year-old man was referred to endoscopic examination for dysphagia. The endoscopic image revealed a ring-shaped scarring of the esophagus suggestive for eosinophilic esophagitis. The IPCL pattern by M-NBI endoscopy showed an inflammatory pattern, and the entire epithelium of the esophagus was not stained by Lugol iodine spraying. Based on six biopsies randomly performed, a poorly differentiated adenocarcinoma was diagnosed. Since the M-NBI pattern and the histology were completely different, EMR−c was performed to obtain large bloc specimens for a more detailed diagnosis. The pathological findings revealed extensive Paget’s cells infiltration into the epithelium and multifocal invasion from the mucosa to the submucosal layer with adenocarcinoma. In conclusion, a large bloc specimen by EMR-c might be more useful than a small biopsy for an accurate diagnosis of the rare esophageal Paget’s disease.
Key words:  –  – .
Abbreviations: EMR−c: endoscopic mucosal resection with cap method; IPCL: intraepithelial papillary capillary loop; LVLs: Lugol-voiding lesions; M-NBI: magnified Narrow Band Imaging; PET-CT: Positron-Emission Tomography and Computed Tomography.

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Published

2017-12-01

How to Cite

1.
Mori H, Ayaki M, Kobara H, Goda Y, Nishiyama N, Masaki T. Rare Primary Esophageal Paget’s Disease Diagnosed on a Large Bloc Specimen Obtained by Endoscopic Mucosal Resection. JGLD [Internet]. 2017 Dec. 1 [cited 2025 Jul. 15];26(4):417-20. Available from: https://jgld.ro/jgld/index.php/jgld/article/view/1013

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Section

Case Reports