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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 343:199-205 July 20, 2000 Number 3
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Case 22-2000— A 74-Year-Old Man with Unrelenting Dysphagia
James S. Allen, and Eric C. Sheffer

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Presentation of Case

A 74-year-old man was referred to the hospital because of worsening dysphagia.

The patient had been in good health until seven months earlier, when dysphagia developed and subsequently worsened, with epigastric and subxiphoid pain. The results of a cardiac stress test were normal. Six and a half months before admission, a double-contrast upper gastrointestinal series (Figure 1) showed a 12-mm stricture at the gastroesophageal junction, with slight spontaneous reflux; the stomach and duodenum appeared normal. An esophagogastroduodenoscopic examination showed a benign-appearing stricture without evidence of a mass. Microscopical examination of biopsy specimens from the esophagus showed squamous epithelium . . . [Full Text of this Article]

Differential Diagnosis

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Dr. James S. Allan's Diagnosis

Pathological Discussion

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