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J Thorac Cardiovasc Surg 2008;135:957-958
© 2008 The American Association for Thoracic Surgery

Brief Communication

Primary esophageal large T-cell lymphoma mimicking esophageal carcinoma: A case report and literature review

Patrick L. Wagner, MDa,b,*, Wayne Tam, MD, PhDb, Pauline Y. Lau, MDc, Jeffrey L. Port, MDa, Subroto Paul, MDa, Nasser K. Altorki, MDa, Paul C. Lee, MDa

a Department of Cardiothoracic Surgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
b Department of Pathology and Laboratory Medicine, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
c Department of Hematology/Oncology, New York Hospital Queens, New York, NY

Received for publication November 13, 2007; accepted for publication December 16, 2007.

* Address for reprints: Patrick L. Wagner, MD, New York-Presbyterian Hospital/Weill Cornell Medical Center, Starr-1036, 525 E 68th St, New York, NY 10021. (Email: plw9001@nyp.org).

The first 20% of the full text of this article appears below.

We report a rare case of primary esophageal T-cell lymphoma. Although these tumors may be difficult to distinguish clinically from more common mass lesions of the esophagus, obtaining an accurate diagnosis is vital to select an appropriate course of treatment.

Clinical Summary

A 64-year-old Chinese man, with no other significant medical history, was seen with a 6-month history of dysphagia, initially with solid food and later progressing to liquids as well. He denied hemoptysis, hematemesis, and weight loss and reported an inactive smoking history of 10 pack-years and occasional alcohol consumption. Results of physical examination were unremarkable, with no palpable lymphadenopathy, ascites, or organomegaly. Initial laboratory values, including blood cell counts, were normal.

A barium swallow suggested external compression of the esophagus. On endoscopy, a polypoid necrotic mass was seen just distal to the upper esophageal sphincter, with associated luminal narrowing (Go Figure 1, A). Endoscopic ultrasonography demonstrated a full-thickness anechoic lesion. Computed tomographic imagery was notable for thickening of the proximal thoracic esophagus and subcentimeter mediastinal lymph nodes (Figure E1). Positron emission tomography revealed marked fluorodeoxyglucose avidity in the esophageal mass.


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  		Figure 1. A, Endoscopic photograph of mass lesion (arrow) and adjacent area of ulceration (. . . [Full Text of this Article]

 





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