Endoscopic resection of co-existing severe dysplasia and a small esophageal leiomyoma

Figure 1 Endoscopic findings. A: Endoscopic findings demonstrate a subepithelial tumor with intact overlying mucosa; B: Chromoendoscopy with narrow band imaging showed scattered brown dots, and dilated and tortuous vessels on the top of the lesion.

Figure 2 Endoscopic ultrasound findings and procedures for endoscopic mucosal resection. A: High frequency ultrasonic endoscopic findings showed a clear homogenous hypoechoic mass derived from the second layer of the esophagus; B: After making a submucosal bleb; C: The subepithelial lesion was captured using a snare; D: No immediate complications occurred after endoscopic mucosal resection.

Figure 3 Histopathologic findings. A: Esophageal leiomyoma arising from the muscularis mucosa (HE, 20 ×); B: Atypical cells in all three areas of the epithelium, but not full thickness, showed severe dysplasia (HE, 200 ×); C: The esophageal leiomyoma was negative for CD117 (C-Kit); D: The esophageal leiomyoma showed strong and diffuse positive staining for smooth muscle actin (200 ×).