A case of superficial esophageal squamous cell carcinoma with lymphoid follicle hyperplasia. That makes it difficult to predict the depth of invasion

Abstract

A 73-year-old man with esophageal squamous cell carcinoma was referred to our hospital for the treatment. The white light endoscopy revealed that the invasion depth was m3-SM1, and NBI magnified endoscopy revealed it was EP-LPM. But Endoscopic ultrasonograhy (EUS) revealed it was SM2. Other evaluation method revealed no metastasis. All things considered, we diagnosed as cT1bN0M0, stageI. This lesion was thought to be outside the guideline for ESD. But the patient strongly requested the endoscopic resection, we decided to perform the ESD. The pathological diagnosis revealed it was SCC, pT1a (LPM) , ly0, v0. The depth of cancer resulted in LPM, but there were a lot of hyperplastic lymphoid follicles under the cancer. This case indicates that it is very difficult to differentiate the cancer from hyperplastic lymphoid follicles and the focal fibrosis by EUS.