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患者,男性,65岁。因进行性吞咽困难40天入院。体检:全身浅表淋巴结不肿大,心肺(-)。血、尿、大便常规及肝肾功能实验室检查正常。B超示肝脾正常.Ⅹ线钡餐及内窥镜检查拟诊为贲门癌,粘膜活检报告为慢性炎症。行贲门癌切除,主动脉弓下食管胃端侧吻合术。病理检查:部分胃及食管一段,胃面积12×10cm,食管长6cm。在贲门小弯侧见一7×7×3cm蕈伞型肿物,累及食管下端,表面有溃烂,切面灰白及灰红色,质软,细腻。镜下:
Patient, male, 65 years old. Dysentery was admitted to hospital for 40 days due to progressive dysphagia. Physical examination: The superficial lymph nodes are not swollen and the heart and lungs (-). Blood, urine, stool routines, and laboratory tests of liver and kidney function were normal. B ultrasound showed normal liver and spleen, X-ray barium meal and endoscopy were diagnosed as cardiac cancer, mucosal biopsy reported as chronic inflammation. Cardiac cancer resection, aortic arch esophagogastric end-to-side anastomosis. Pathological examination: part of the stomach and esophagus, stomach area 12 × 10cm, esophageal length 6cm. A 7×7×3cm parachute-type mass was seen on the minor curve side of the fontanelle, involving the lower end of the esophagus. The surface was ulcerated, and the cut surface was gray and gray-red. The texture was soft and delicate. Under the microscope: