inverted endoscopic view on the
left photo shows a polypoid tumor at the
cardial junction. On the right
side the tumor is depicted in an antegrad way.
The esophageal lumen is obstructed considerably.
Histologic work-up found cells
highly suspicious of malignancy. Additionally the
cells were tested immunhistochemically
positive for the epitheleal marker Pan-Zytokeratin.
Thus an infiltration of the submucosa
by an adenocarcinoma with signet- ring like cells was
present in this patient.
An increasing fraction of the esophageal tumors are
originating from the distal esophagus , presumably
from Barrett epithelum. The cells of
these tumors do sometimes also show the pattern of a
signet- ring, owing to a high content
of cellular mucus.