Figure 2.

A case which biopsy of the primary lesion was challenging (63 years old male, suspected diagnosis was esophageal carcinoma). (A) Suspected esophagal carcinoma; however, biopsy of the primary lesion was negative. (B) Swollen cardiac lymph node. Pink arrow indicates the swollen lymph node in the computed tomographic scan. (C) Endoscopic ultrasound-guided fine needle aspiration was performed using 22-gauge needle. The lymph node was punctured using the needle. (D) Squamous cell carcinoma. (E) ESD was performed for diagnosis. This was the specimen following ESD. (F) Esophageal carcinoma diagnosis. ESD, endoscopic submucosal dissection.