Barrett's esophagus with high-grade dysplasia simulating metastatic adenocarcinoma in a fine needle aspiration biopsy.
An endoscopic ultrasound examination, performed to rule out invasive esophageal carcinoma in a patient with a history of Barrett's esophagus with high-grade dysplasia, disclosed an enlarged paraesophageal lymph node which was aspirated. The aspirate contained markedly atypical clustered large cells that displayed prominent nucleoli and mitoses, as well as lymphoid cells, suggestive of adenocarcinoma metastatic to a lymph node. The neoplastic-appearing cells were, in fact, dysplastic glandular cells that the needle traversed en route to a reactive lymph node. The case represents a rare instance in which Barrett's esophagus with high-grade dysplasia was discerned on fine needle aspiration (FNA) biopsy and highlights a potential pitfall in FNA.
Gutmann
Edward J
EJ
Department of Pathology, Dartmouth-Hitchcock Medical Center and Dartmouth Medical School, Lebanon, New Hampshire 03756, USA. edward.j.gutmann@dartmouth.edu
Suriawinata
Arief
A
Gordon
Stuart
S
D000230:Adenocarcinoma / Q000556:secondary*; D000328:Adult; D001471:Barrett Esophagus / Q000473:pathology* / Q000601:surgery; D044963:Biopsy, Fine-Needle; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D019160:Endosonography; D004938:Esophageal Neoplasms / Q000473:pathology*; D006801:Humans; D008297:Male; D011230:Precancerous Conditions / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome