Esophageal stricture - A cascade of complications

*Beatriz Chambino1; Sérgio Maltês2; Claudio Gonçalves Gouveia1; Cristiana Camacho1; Pedro Neves Ferreira1; Luís Campos1,3

1Internal Medicine Department, Hospital de São Francisco Xavier, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
2Cardiology Department, Hospital de Santa Cruz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
3NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa. Lisbon, Portugal.

*Corresponding author

*Beatriz Chambino , Internal Medicine Department, Hospital de São Francisco Xavier, Centro Hospitalar
Lisboa Ocidental, Lisbon, Portugal

Manuscript

A 90-year old male diagnosed with stage III non-Hodgkin's peripheral T-cell lymphoma under palliative treatment was admitted due to a feeling of food impaction and vomiting. He underwent upper digestive endoscopy which revealed an extensively necrotic esophageal mucosa with complete esophagus obstruction where two impacted pills were seen (figure 1) and fragmented. Non-contrast chest computed tomography showed multiple exuberant mediastinal adenopathies conditioning extrinsic compression and esophageal collapse (figure 2). Patient later underwent endoscopic reassessment which showed complete mucosa healing, therefore proceeding with esophageal stenosis endoluminal balloon dilation.

fig 1 3
fig 2 3

Mediastinal adenopathies due to peripheral T cell-lymphoma are rare1,2. This case represents an unusual example of extrinsic esophageal compression due to lymphoma1,2 leading to severe pill- induced esophagitis3.

REFERENCES

  1. Sharma M, Aronow WS, O'Brien M, Gandhi K, Amin H, Desai H. T cell lymphoma presenting as esophageal obstruction and bronchoesophageal fistula. Med Sci Monit. 2011;17(6):CS66-CS69. doi:10.12659/msm.881797
  2. Kulkarni, Archana MBBS, MD; Arif, Hamza MD; Holleran, Kathleen MD An Unusual Cause of Dysphagia From External Compression of the Esophagus by B-Cell Lymphoma, American Journal of Gastroenterology: October 2017 - Volume 112 - Issue - p S919
  3. Saleem F, Sharma A. Drug Induced Esophagitis. [Updated 2020 Jun 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https:// www.ncbi.nlm.nih.gov/books/NBK549818/
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