Clinical, endoscopic and histopathological observation of a rare case of esophageal submucosal gland duct adenoma: A case report

Figure 1 Endoscopic images of esophageal submucosal gland duct adenoma. A: The hemispherical polyp was located at the gastro-esophageal junction with superficial erosion of the surface mucosa; B: Ultrasound endoscopy showed an anechoic lesion located in the submucosa with a clear and smooth boundary; C: Magnifying narrow-band imaging endoscopy revealed a mass with borderless mucosal surface along with a slightly irregular microstructure, twisted and thickened glands, but regular microvessels; D: Gross observation showed a hemispherical bulge on the surface of the specimen removed by endoscopic submucosal dissection, and the surface mucosa was smooth.

Figure 2 Pathological images of esophageal submucosal gland duct adenoma. A: The orange arrow denoted the submucosal lesion within the esophagus (original magnification × 40); B and C: The lesion was composed of ducts or cysts containing papillary and tubular structures with lymphocytic infiltrates in the interstitial (B: Original magnification × 100, C: Original magnification × 200); D: Tumor cells were composed of moderate bilayer epithelium with no mitotic figures (original magnification × 400); E: CK7 was positive in inner cells and negative in outer cells (original magnification × 200); F: P63 was negative in inner cells and positive in outer cells (original magnification × 200); G: All cells were negative for MUC5AC (original magnification × 200); H: Ki-67 showed only expression in a few myoepithelial cells(original magnification × 400).