Editor's quiz: GI snapshot
Dysphagia and an oesophageal stricture; not always cancer
Department of Internal Medicine and Gastroenterology, Groene Hart Ziekenhuis, Gouda, The Netherlands
Correspondence to:
Dr J T M van der Heyden, Postbus 1098, 2800 BB Gouda, The Netherlands; hans.vander.heyden@ghz.nl
| The first 150 words of the full text of this article appear below. |
CLINICAL PRESENTATION
A 48-year-old Caucasian male was referred to the hospital because of dysphagia. Medical history included a pleuritis and alcohol abuse. For 6 months he had been suffering from pain and regurgitation after ingestion of solid food. He reported a 6 kg weight loss in the past 6 months.
Physical examination showed no abnormalities, and routine laboratory studies as well as a chest x ray were unremarkable. Initial endoscopy revealed a concentric stricture just below the upper oesophageal sphincter. The mucosa around the stricture was not ulcerated. With some difficulty a thin endoscope was manoeuvred through the stricture. Distal from the stricture, the mucosa was covered with white plaques, suspicious for Candida oesophagitis. Since oesophageal cancer was suspected, multiple biopsies of the stricture and distal oesophagus were taken. However, histopathological examination revealed squamous epithelium with neutrophil infiltration and the presence of Candida albicans, without signs of malignancy.
The patient was
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ANSWER
Gut 2008 57: 1040.[Extract] [Full Text] [PDF]
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