No abstract

No abstract

No abstract

No abstract

Figure 1. A: CT A/P (axial) showing findings concerning for interstitial edematous pancreatitis (red arrow). B: CT A/P (axial) showing moderate left pleural effusion associated with multisegmental left lower lobe collapse (red and blue arrows) and numerous pulmonary nodules (green arrows). C: CT Chest (axial) showing diffuse circumferential esophageal and gastric wall thickening, most pronounced at the gastroesophageal junction (red arrow). D: CT Chest (axial) showing innumerable bilateral solid pulmonary nodules and mild mediastinal and upper abdominal lymphadenopathy (red arrow). E: MRIA/P (coronal) showing diffuse wall thickening of the gastroesophageal junction and stomach (red arrow). F: Endoscopy of distal esophagus demonstrating mucosaL nodularity. G: Endoscopy of proximal esophagus demonstrating nodularity. H: Endoscopy of esophagus under narrow band imaging, demonstrating nodularity and mucosal changes. I: Endoscopy showing large fungating GEJ mass with mucosal bleeding. J: Retroflexion view of large fungating GEJ mass with extensive gastric mucosal nodularity. Pathology slides: Pathology slides of biopsies with p53 stain demonstrating differential p53 stain where poorly differentiated areas had a positive expression and loss of expression in better differentiated areas. Final genetics: pMMR, MSI-stable, TMB 3, no actionable mutations, HER2 FISH negative. MSH6 VUS was detected; genetics evaluation also showed MSH6 VUS; PDL1 IHC 1% (CPS).