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Journal of the American Osteopathic Association


A retrospective study of five patients with primary adenocarcinoma of the esophagus complicating columnar epithelium lined (Barrett's) esophagus was carried out. All patients demonstrated dysphagia which had been present for from 2 months to 17 years, often associated with weight loss, hiatal hernia, and melena. The location of the lesions varied from the middle third to lower third of the esophagus. Microscopically the lesions ranged from focal, well-differentiated adenocarcinoma to metastasizing, poorly differentiated lesions. The mucosa adjacent to the adenocarcinoma contained a spectrum of abnormalities ranging from dysplasia to carcinoma in situ. Cytologic examination and multiple biopsies are the recommended approach in cases of suspected columnar epithelium lining the esophagus. It is hoped that this will lead to early diagnosis of any malignant transformation of the epithelium and, with esophageal excision, to improved prognosis.

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