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* [[Ulcer|Ulcerating]], fungating mass.  
* [[Ulcer|Ulcerating]], fungating mass.  
** Location:
** Location:
*** Squamous cell carcinoma is usually found in the mid-third of the esophagus
*** Squamous cell carcinoma is usually found in the mid-third of the esophagus.
*** Adenocarcinoma is usually found in the lower third of the esophagus near the gastric opening.
*** Adenocarcinoma is usually found in the lower third of the esophagus near the gastric opening.
===Microscopic pathology===
===Microscopic pathology===
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**[[Mitosis|Mitotic activity]]
**[[Mitosis|Mitotic activity]]


====Squamous cell carcinoma====
====Squamous cell carcinoma:====


*Atypical squamous cells invade the [[basement membrane]] <ref>{{Cite web | title =Squamous cell carcinoma of the esophagus| url =http://librepathology.org/wiki/index.php/Squamous_cell_carcinoma_of_the_esophagus }}</ref>
*Atypical squamous cells invade the [[basement membrane]] <ref>{{Cite web | title =Squamous cell carcinoma of the esophagus| url =http://librepathology.org/wiki/index.php/Squamous_cell_carcinoma_of_the_esophagus }}</ref>

Revision as of 15:20, 14 December 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Overview

The pathophysiology of esophageal cancer depends on the histological subtype.

Pathophysiology

The esophagus is lined by nonkeratinized stratified squamous epithelium. This lining is maintained as long as there are no stressors leading to a metaplastic change. These stressors may include genetic factors, chronic alcoholism, smoking, ingesting spicy foods and hot liquids frequently, and chronic gastroesophageal reflux. Eventually, a dysplastic change occurs followed by a metaplastic change, which may be squamous cell carcinoma or adenocarcinoma.[1]

Pathology

Gross pathology

Squamous cell carcinoma or adenocarcinoma of the esophagus may appear as:[2]

  • Flat and irregular plaque
  • Polypoid lesion
  • Ulcerating, fungating mass.
    • Location:
      • Squamous cell carcinoma is usually found in the mid-third of the esophagus.
      • Adenocarcinoma is usually found in the lower third of the esophagus near the gastric opening.

Microscopic pathology

Nuclear atypia of malignancy:

Squamous cell carcinoma:

  • Atypical squamous cells invade the basement membrane [3]
    • Cytology of squamous cells:
      • Nucleus - typically central
      • High mitotic activity
      • Eosinophilic cytoplasm
      • Squamous whorls or keratin pearls
Esophageal squamous cell carcinoma by Nephron - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=31284085

Adenocarcinoma

  • Atypical adenomatous cells show:
Esophageal adenocarcinoma by Nephron - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=12475495

References

  1. Quante M, Graham TA, Jansen M (2017). "Insights into the Pathophysiology of Esophageal Adenocarcinoma". Gastroenterology. doi:10.1053/j.gastro.2017.09.046. PMID 29037468.
  2. Sugarbaker, David (2015). Adult chest surgery. New York: McGraw-Hill Education. ISBN 0071781897.
  3. "Squamous cell carcinoma of the esophagus".
  4. "Esophageal adenocarcinoma".


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