A 65-Year-Old Man Comes to the Office with Dysphagia

A 65-year-old man comes to the office with dysphagia.  For the last 3 months, he has relied on protein shakes and juices for nourishment as he has had difficulty swallowing solid foods.  He has also had a diminished appetite and an estimated weight loss of 9.1 kg (20 lb) .  Medical history includes hyperlipidemia, emphysema, and previous episodes of pancreatitis.  Family history includes lung cancer in his mother.  The patient smoked a pack of cigarettes daily for 50 years but quit 2 years ago.  He has been drinking a fifth (750 mL) of vodka weekly for the last decade.  Vital signs are normal.  BMI is 19.2 kg/m².  Temporal wasting is present but physical examination is otherwise unremarkable.  Upper endoscopy reveals a 4-cm mass in the middle third of the esophagus, and several biopsies are taken.  Thoracic imaging reveals mediastinal lymphadenopathy.  Histologic evaluation of the biopsy specimens will most likely show which of the following in this patient?

A) Intestinal cells without dysplasia
B) Irregular glandular cells with tissue invasion
C) Keratin pearls and intercellular bridges
D) Myocytes with prominent atypia
E) Spindle cells expressing CD117

Correct Answer:

Verified

Unlock this answer now
Get Access to more Verified Answers free of charge

Access For Free