慢性食管炎误诊为食管、贲门肿瘤(附10例报告)

Chronic Esophagitis Erroneously Diagnosed as Carcinoma.A Report of 10 Cases

1963年5月～1984年6月我院收治10例慢性食管炎误诊为食管及胃贲门肿瘤,均行手术治疗。患者均为男性,年龄25～67岁,中位年龄49.5岁。临床症状:吞咽困难9例,消化道溃疡症状2例,呕吐及食管异物感2例。上消化道X线检查发现:食管管腔狭窄9例,硫酸钡分流象2例,食管壁充盈缺损6例,食管管壁僵硬4例,食管软组织阴影2例。放射诊断为食管癌8例,食管平滑肌瘤1例及怀疑贲门癌1例。8例行内窥镜检查,其表现为病变周围粘膜充血者8例,肿瘤结节7例,食管平滑肌瘤征1例,镜检活检均为慢性炎症。术前诊断均为食管与贲门肿瘤。9例行病变切除及1例未能切除而行捷径术。手术标本病理诊断定为慢性非特异性炎症。

From May 1963 to June 1984, 10 patients with chronic esophagitis misdiagnosed preoperatively either as carcinoma of the esophagus or gastric cardia are reported. All of the patients are males. Their ages ranged from 25 to 67 years, with a mean of 49.5. Dysphagia of varying degrees was present in 9 cases and peptic ulcer pain, retrosternal pain, loss of weight, vomiting, foreign body sensation were noted in 2 each. Roentgenographic study showed narrowing of esophagus in 9, divergence of barium stream in 2, filling defect in 6, rigidity of esophageal wall in 4, distention of upper esophagus in 3, and soft tissue mass shadow in 2. In 8 cases of this series endoscopic features disclosed congestion of mucosa surrounding the lesion in 8 all, nodular mucosal protrusion in 7 and leiomyomatous appearance in 1, however, biopsy pathology revealed only inflammation. Nine cases underwent esophagectomy and bypass operation was done in 1 seemingly unresectable case.