Polypoid Barrett’s High-Grade Dysplasia in a Patient with Familial Adenomatous Polyposis: a Unique Association

H. C. Wolfsen

doi:10.1055/s-2005-861024

Endoscopy, Inhaltsverzeichnis

Endoscopy 2005; 37(3): 280
DOI: 10.1055/s-2005-861024

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Polypoid Barrett’s High-Grade Dysplasia in a Patient with Familial Adenomatous Polyposis: a Unique Association

H. C. Wolfsen¹

¹Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA

Abstract

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Figure 1 A 30-year-old white man with familial adenomatous polyposis (FAP) was referred for evaluation of Barrett’s esophagus with high-grade dysplasia, an association not previously reported. Diagnosed during adolescence with FAP, he had undergone proctocolectomy in 1996. Subsequently, screening endoscopy for duodenal polyps detected long-segment Barrett’s glandular mucosa replacing most of the esophageal mucosa (14 cm segment length), with polypoid changes. Similar-appearing polyps were noted throughout the stomach and duodenum.

Figure 2 The histopathology section demonstrates overlying normal esophageal squamous mucosa, undermined by Barrett’s glandular epithelium with high-grade dysplasia. The patient declined invasive treatment with porfimer sodium photodynamic therapy or esophageal resection. Medical therapy with a nonselective nonsteroidal anti-inflammatory drug, combined with high-dose proton-pump inhibitor treatment, was initiated.

Endoscopy_UCTN_Code_CCL_1AB_2AC_3AC

Abbildungen

Figure 1 A 30-year-old white man with familial adenomatous polyposis (FAP) was referred for evaluation of Barrett’s esophagus with high-grade dysplasia, an association not previously reported. Diagnosed during adolescence with FAP, he had undergone proctocolectomy in 1996. Subsequently, screening endoscopy for duodenal polyps detected long-segment Barrett’s glandular mucosa replacing most of the esophageal mucosa (14 cm segment length), with polypoid changes. Similar-appearing polyps were noted throughout the stomach and duodenum.

Figure 2 The histopathology section demonstrates overlying normal esophageal squamous mucosa, undermined by Barrett’s glandular epithelium with high-grade dysplasia. The patient declined invasive treatment with porfimer sodium photodynamic therapy or esophageal resection. Medical therapy with a nonselective nonsteroidal anti-inflammatory drug, combined with high-dose proton-pump inhibitor treatment, was initiated.