Lymphoepithelial cyst of the upper esophagus.

gastroduodenoscopy as part of a general checkup at a private clinic, and was referred to our hospital with a suspected submucosal tumor of the esophagus. The patient had no symptoms and was in good health except that he was taking aspirin for angina pectoris, although he had not experienced any cardiac events in the past 6 years. On physical examination, the abdomen was flat and soft. Laboratory findings were within normal limits. The endoscopic examination showed a small submucosal tumor 22 cm from the incisors below the upper esophageal sphincter (●" Fig. 1). Endoscopic ultrasonography showed a low echoic tumor, 5 × 4mm in size, in the submucosal layer of the esophagus (●" Fig. 2). The tumorwas removedby endoscopic mucosal resection using a snare and sent for histological examination. The resected tumor was 9 × 7 × 4mm in size. A unilocular cyst was found below the esophagealmucosa. The cyst was lined by stratified squamous epithelium surrounded by a florid lymphoid hyperplasia with germinal centers (●" Fig. 3). The histopathological examination confirmed the diagnosis of lymphoepithelial cyst. We plan to follow up the patient with gastroendoscopy in 1 year. Lymphoepithelial cysts characteristically have a lining of stratified squamous epithelium and a complete or incomplete band of lymphoid tissue, resembling a lymph node. They are most often found in the lateral aspect of the neck or in the parotid gland [1] and are rarely found in other organs. Lymphoepithelial cysts of the esophagus are very rare. Since the first report of an esophageal lymphoepithelial cyst by Kataoka et al. in 1999 [2], two more cases have been reported [3,4]. All of them consisted of a submucosal tumor with a smooth lining, a homogeneous structure, and an echogenicity similar to the muscle layer on the endoscopic ultraLymphoepithelial cyst of the upper esophagus