Esophageal cancer pathophysiology: Difference between revisions
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==Pathophysiology== | ==Pathophysiology== | ||
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]]. | 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]]. Eventually, a [[Dysplasia|dysplastic]] change occurs followed by a [[Metaplasia|metaplastic]] change, which may be [[Squamous cell carcinoma|squamous cell]] carcinoma or [[adenocarcinoma]].<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 | [[Squamous cell carcinoma]] or [[adenocarcinoma]] of the [[esophagus]] may appear as: | ||
* Flat and irregular [[plaque]] | |||
* Polypoid lesion | |||
* [[Ulcer|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.<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=== | ||
Revision as of 15:12, 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:
- 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.[2]
- Location:
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".