title: Esophageal anthracosis: lesion mimicking malignant melanoma.
abstract: A case of anthracosis of the esophagus is reported. The patient was a previously healthy 69-year-old Japanese woman. A black and slightly elevated lesion was detected in her esophagus by upper gastroesophageal fiberoscopic examination. Endoscopically, the lesion looked like malignant melanoma. Thoracic esophagotomy was then performed. Histological examination revealed a pigmented lesion beneath the mucosal epithelial layer. The lesion consisted of an aggregation of histiocytes containing an abundance of tiny black pigments. A few mature lymphocytes and plasma cells were also evident in the periphery of the lesion. Histologically, these findings looked like lymph nodes in the pulmonary hilus; however, no lymph nodal structure was evident in the esophageal wall. Traction diverticula were also noted in the pigmented lesion. The patient has remained well without disease for 9 months since the surgery. Although anthracosis is a rare condition in the esophagus, the present case gave warning to pathologists and clinicians that it does indeed occur. Endoscopists and pathologists should differentiate anthracosis from malignant melanoma because the treatment and outcome are quite different for each.
authors.affiliation: Department of Pathology and Clinical Laboratories, JA Suzuka Hospital, Japan. murata@sch.miekosei.or.jp
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Murata
authors.forename: Takazumi
authors.initials: T
authors.lastname: Imai
authors.forename: Ken-Ichiro
authors.initials: K
authors.lastname: Hoshino
authors.forename: Masami
authors.initials: M
authors.lastname: Kato
authors.forename: Kenji
authors.initials: K
authors.lastname: Tanigawa
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Higuchi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kozuka
authors.forename: Rie
authors.initials: R
authors.lastname: Inoue
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Watanabe
authors.forename: Taizo
authors.initials: T
authors.lastname: Shiraishi
authors.forename: Kaiyo
authors.initials: K
authors.lastname: Takubo
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D004935:Esophageal Diseases / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008545:Melanoma / Q000378:metabolism / Q000473:pathology*; D011009:Pneumoconiosis / Q000378:metabolism / Q000473:pathology*