Esophageal cancer pathophysiology: Difference between revisions
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==Overview== | ==Overview== | ||
The pathophysiology of esophageal cancer depends on the histological subtype. | The pathophysiology of [[esophageal cancer]] depends on the [[Histology|histological]] subtype. | ||
==Pathophysiology== | ==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. Over time a dysplastic change occurs followed by a metaplastic change which may be of the squamous cell or adenocarcinoma type.<ref name="pmid29037468">{{cite journal |vauthors=Quante M, Graham TA, Jansen M |title=Insights into the Pathophysiology of Esophageal Adenocarcinoma |journal=Gastroenterology |volume= |issue= |pages= |year=2017 |pmid=29037468 |doi=10.1053/j.gastro.2017.09.046 |url=}}</ref> | The esophagus is lined by nonkeratinized stratified [[Squamous epithelium|squamous]] epithelium. This lining is maintained as long as there are no stressors leading to a [[Metaplasia|metaplastic]] change. These stressors may include [[Genetics|genetic]] factors, chronic [[alcoholism]], [[smoking]], ingesting spicy foods and hot liquids frequently, and [[Gastroesophageal reflux disease|chronic gastroesophageal reflux]]. Over time a [[Dysplasia|dysplastic]] change occurs followed by a [[Metaplasia|metaplastic]] change which may be of the [[Squamous cell carcinoma|squamous cell]] or [[adenocarcinoma]] type.<ref name="pmid29037468">{{cite journal |vauthors=Quante M, Graham TA, Jansen M |title=Insights into the Pathophysiology of Esophageal Adenocarcinoma |journal=Gastroenterology |volume= |issue= |pages= |year=2017 |pmid=29037468 |doi=10.1053/j.gastro.2017.09.046 |url=}}</ref> | ||
==Pathology== | ==Pathology== | ||
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===Gross pathology=== | ===Gross pathology=== | ||
Squamous cell carcinoma or adenocarcinoma of the esophagus may appear as a flat, irregular plaque or a polypoid lesion or an ulcerating, fungating mass.<ref>{{cite book | last = Sugarbaker | first = David | title = Adult chest surgery | publisher = McGraw-Hill Education | location = New York | year = 2015 | isbn = 0071781897 }}</ref> | [[Squamous cell carcinoma]] or [[adenocarcinoma]] of the [[esophagus]] may appear as a flat, irregular [[plaque]] or a [[Polyp|polypoid]] lesion or an [[Ulcer|ulcerating]], fungating mass.<ref>{{cite book | last = Sugarbaker | first = David | title = Adult chest surgery | publisher = McGraw-Hill Education | location = New York | year = 2015 | isbn = 0071781897 }}</ref> | ||
===Microscopic pathology=== | ===Microscopic pathology=== | ||
====Nuclear atypia of malignancy:==== | ====Nuclear [[atypia]] of malignancy:==== | ||
*Found in both types: | *Found in both types: | ||
**Size variation | **[[Pleomorphism|Size variation]] | ||
**Shape variation | **[[Pleomorphism|Shape variation]] | ||
**Staining variation | **[[Staining|Staining variation]] | ||
**Mitotic activity | **[[Mitosis|Mitotic activity]] | ||
====Squamous cell carcinoma==== | ====Squamous cell carcinoma==== | ||
Atypical squamous cells with invasion through the basement membrane: | Atypical squamous cells with invasion through the [[basement membrane]]: | ||
*Cytology: | *Cytology: | ||
**Nucleus - typically central | **Nucleus - typically central | ||
**Mitotic activity | **Mitotic activity | ||
**Cytoplasm - "dense-appearing", typically eosinophilic (may be intensely eosinophilic) | **Cytoplasm - "dense-appearing", typically [[Staining|eosinophilic]] (may be intensely eosinophilic) | ||
**Squamous whorls or ''keratin pearls'' may be present<ref>{{Cite web | title =Squamous cell carcinoma of the esophagus | **Squamous whorls or ''keratin pearls'' may be present<ref>{{Cite web | title =Squamous cell carcinoma of the esophagus | ||
| url =http://librepathology.org/wiki/index.php/Squamous_cell_carcinoma_of_the_esophagus }}</ref> | | url =http://librepathology.org/wiki/index.php/Squamous_cell_carcinoma_of_the_esophagus }}</ref> | ||
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====Adenocarcinoma<ref>{{Cite web | title =Esophageal adenocarcinoma| url =http://librepathology.org/wiki/index.php/Esophageal_adenocarcinoma#Microscopic }}</ref>==== | ====Adenocarcinoma<ref>{{Cite web | title =Esophageal adenocarcinoma| url =http://librepathology.org/wiki/index.php/Esophageal_adenocarcinoma#Microscopic }}</ref>==== | ||
*Invading cell clusters or glands | *Invading cell clusters or [[Gland|glands]] | ||
*Cribriforming (more than rare) or desmoplasia or "deep" invasion (into submucosa) | *Cribriforming (more than rare) or [[desmoplasia]] or "deep" invasion (into submucosa) | ||
Revision as of 15:05, 6 December 2017
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Esophageal cancer Microchapters |
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Esophageal cancer pathophysiology On the Web |
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American Roentgen Ray Society Images of Esophageal cancer pathophysiology |
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Risk calculators and risk factors for Esophageal cancer pathophysiology |
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. Over time a dysplastic change occurs followed by a metaplastic change which may be of the squamous cell or adenocarcinoma type.[1]
Pathology
Gross pathology
Squamous cell carcinoma or adenocarcinoma of the esophagus may appear as a flat, irregular plaque or a polypoid lesion or an ulcerating, fungating mass.[2]
Microscopic pathology
Nuclear atypia of malignancy:
- Found in both types:
Squamous cell carcinoma
Atypical squamous cells with invasion through the basement membrane:
- Cytology:
- Nucleus - typically central
- Mitotic activity
- Cytoplasm - "dense-appearing", typically eosinophilic (may be intensely eosinophilic)
- Squamous whorls or keratin pearls may be present[3]
Adenocarcinoma[4]
- Invading cell clusters or glands
- Cribriforming (more than rare) or desmoplasia or "deep" invasion (into submucosa)
References
- ↑ 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.
- ↑ Sugarbaker, David (2015). Adult chest surgery. New York: McGraw-Hill Education. ISBN 0071781897.
- ↑ "Squamous cell carcinoma of the esophagus".
- ↑ "Esophageal adenocarcinoma".