Fig. 6

Excised specimen (left section). The esophagus is dilated, and the mucosal surface is rough. Arrowheads indicate the lesion and arrows indicate the endoscopic submucosal dissection scars. Histopathological findings (a–d): a atrophy of inner circular muscle (desmin staining; magnification, ×25), b missing inner circular and outer longitudinal muscle (desmin staining; magnification, ×20) *Im: inner circular muscle, Om: outer longitudinal muscle. Note the loss and atrophy of muscularis propria extending from the esophagogastric junction to the oral side, c missing inner circular muscle in the stomach area (desmin staining; magnification, ×10), d missing ganglion cells in Auerbach’s plexus (CD56 staining; magnification, ×25, ×100) *Im: inner circular muscle, Om: outer longitudinal muscle