case_images: PMC4062238_01
case_images: Barium swallow showing irregular narrowing in the distal esophagus (black arrow).
case_images: EU-2-35-g001.jpg
case_images: PMC4062238_01_EU-2-35-g001.jpg
case_images: F1
case_images: Barium swallow showed moderate fixed narrowing in the distal thoracic esophagus (Fig. 1).
case_images: Computed tomography showing thickening wall in the distal esophagus (white arrow) as well as the proximal stomach. Massive ascites was also shown.
case_images: EU-2-35-g002.jpg
case_images: PMC4062238_01_EU-2-35-g002.jpg
case_images: F2
case_images: Esophageal mucosa appeared to be normal (Fig. 2).
case_images: Upper endoscopy showing stricture was found in the lower esophagus starting at 35 cm and extending to 40 cm from the incisors with normal mucosa.
case_images: EU-2-35-g003.jpg
case_images: PMC4062238_01_EU-2-35-g003.jpg
case_images: F3
case_images: Computed tomography showed thickened distal esophagus and proximal stomach wall, mild intrahepatic biliary dilatation, massive ascites and right-sided hydronephrosis (Fig. 3).
case_images: Endoscopic ultrasound with a 12 MHz mini-probe showed thickened esophageal wall without normal esophageal wall layer pattern.
case_images: EU-2-35-g004.jpg
case_images: PMC4062238_01_EU-2-35-g004.jpg
case_images: F4
case_images: It showed approximately 10 mm thickened esophageal wall disruption of the normal esophageal wall layer pattern (Fig. 4).
case_images: Endoscopic ultrasound showing the esophageal wall thickening (white arrow) and EUS-guided fine needle aspiration (white arrow head) was done.
case_images: EU-2-35-g005.jpg
case_images: PMC4062238_01_EU-2-35-g005.jpg
case_images: F5
case_images: After confirming the absence of major blood vessels, EUS-FNA of thickened esophageal wall was performed with a 22- and 25-G needle (Fig. 5).