病历摘要:男,57岁,入院前三个月自觉进食受阻,近一个月来症状加重并偶有胸骨后疼痛。曾在县医院按胃病治疗,症状未缓解,现能进半流汁。查体:贫血貌,浅部淋巴结未触及,心肺正常,肝脾不大。血红蛋白7g。食管造影:食管下段钡流通过不畅,有长约4～5cm的不规则狭窄,管壁僵硬,不能扩张,粘膜破坏,贲门正常。诊断为食管下段癌。经小量间断输血500mL,血红蛋白提高至11.6g后开胸探查:食管下段触及2×1cm肿块,该段食管肌层变厚。手术行食管切除,食管胃端侧吻合术。病理证实:食管消化性溃疡,伴溃疡边缘上皮呈非典型增生。讨论:某些食管良性疾患与食管癌在临床及X线表现极为相似,易造成误诊。国内报道误诊率为1.02～1.3％。本例误诊教训为:(1)国内外统计 Medical history summary: Male, 57 years old, three months before admission, consciously stop eating, the symptoms have increased in recent months and occasional sternal pain. According to stomach treatment in the county hospital, the symptoms did not ease, now can enter half-juice. Physical examination: anemia, shallow lymph nodes not touched, normal heart and lungs, liver and spleen is not. Hemoglobin 7g. Esophageal angiography: Esophageal barium flow through the poor, there are about 4 ~ 5cm irregular stenosis, wall stiffness, can not be expanded, mucosal damage, cardia normal. Diagnosis of lower esophageal cancer. After a small amount of intermittent blood transfusions 500mL, hemoglobin increased to 11.6g after thoracotomy exploration: lower esophageal reach 2 × 1cm mass, the section of the thickening of the esophageal muscle. Surgical esophagectomy, esophagogastric anastomosis. Pathology confirmed: Esophageal peptic ulcer, with the edge of the ulcer atypical hyperplasia. Discussion: Some esophageal benign diseases and esophageal cancer in the clinical and X-ray findings are very similar, easily lead to misdiagnosis. The domestic misdiagnosis rate was 1.02 ~ 1.3%. The cases of misdiagnosis as follows: (1) Statistics at home and abroad