Abstract
A case of early esophageal adenocarcinoma arising from short segment Barrett esophaguswas reported. A 78-year-old man was admitted to our hospital because of abnormal shadowin gastro-intestinal series of the mass survey. Endoscopic examination revealed a nodularsurfaced O-Ila type elevated lesion 15mm in diameter in a columnar epitherium lined esophagusof which the longest part was 2.5cm from the esophago-gastric junction Mechylene blue(MB)stained the elevated lesion slightly and its's anal-side mucosa strongly, which suggested thatintestinal mataplasia existed, and clarified the border between the lesion and it's surroundingmocosa. Biopsy specimen from the lesion revealed low garade dysplasia, so diagnosis of lowgrade dysplasia arising from short segment Barrett esophagus was made. Endoscopic mucosalresection was performed. Pathological examination of the resected specimen showed welldifferentiated adenocarcinoma and intestinal metaplasia in it's surrounding mucosa. MBselectively stains intestinal mataplasia in Barrett's esophagus. Dysplasia, which mostly asrisesfrom intestinal mataplasia, will be stained slightly or unstained by MB like gastric adenomaarising from intestinal metaplasia. MB staining method is considered to be useful for diagnosisof intestinal metaplasia and dysplasia in Barrett's esophagus.
