{"knowledge_schema": {"broad_category": "Medicine \u2192 Gastroenterology \u2192 Esophageal Disorders", "refinement": "This problem involves diagnosing a patient with esophageal symptoms and imaging findings, considering various potential causes of esophageal narrowing and inflammation.", "specific_scope": "The focus is on identifying the most likely diagnosis based on clinical presentation, lab results, imaging studies, and endoscopic findings.", "goal": "Determine the most probable diagnosis for the patient's esophageal condition based on the provided clinical information."}, "summary": "In this clinical scenario, a 53-year-old woman presents with severe chest pain and swallowing difficulties, alongside imaging findings of esophageal lumen narrowing and wall thickening. The absence of erythema, ulcers, or strictures during endoscopy suggests a non-infectious etiology. Given her history of alcohol use, smoking, and the imaging results, the most likely diagnosis is esophageal adenocarcinoma, which is consistent with her risk factors and the findings of esophageal narrowing."}