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患者,男,62岁。进行性吞咽困难半年余。吸烟20年,约5 000支/年。胃镜检查见距门齿25~33 cm处黏膜糜烂,结节样改变,碘染不着色,粉红色征阳性,累及管腔全周,活检提示鳞状上皮高级别上皮内瘤变,局灶区鳞状细胞癌形成。食管造影示食管中下段管腔变窄,黏膜破坏,病变长度约1.7 cm,管壁僵硬。胸部CT检查提示,食管中段管壁增厚约1.1 cm,管腔狭窄,肺门及纵隔淋巴结未见肿大,双肺未见异常。颅脑及腹部CT检查未见异常。纤维支气管镜检查提示,右上叶支气管内后壁浸润性新生物,
Patient, male, 62 years old. Progressive dysphagia more than six months. 20 years of smoking, about 5,000 per year. Gastroscopy from the incisors 25 to 33 cm at the mucosal erosion, nodular change, iodine staining, pink sign positive, involving the entire lumen, biopsy prompted high-grade squamous intraepithelial neoplasia, focal zone scales Hepatocellular carcinoma formation. Esophageal angiography shows that the lower lumen of the esophagus is narrowed and the mucosa is damaged. The length of the lesion is about 1.7 cm and the wall of the esophagus is stiff. Chest CT examination showed that the middle esophageal wall thickening of about 1.1 cm, lumen stenosis, hilar and mediastinal lymph nodes did not enlarge, no abnormal lungs. Brain and abdominal CT examination showed no abnormalities. Fiberoptic bronchoscopy prompted the right upper lobe of bronchial wall invasive neoplasms,