Esophageal cancer pathophysiology
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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. 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.
Microscopic pathology
Nuclear atypia of malignancy:
- Found in both types:
- Size variation
- Shape variation
- Staining variation
- Mitotic activity
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[2]
Adenocarcinoma[3]
- 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.
- ↑ "Squamous cell carcinoma of the esophagus".
- ↑ "Esophageal adenocarcinoma".