Difference between revisions of "Squamous cell carcinoma of the esophagus"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Esophageal_squamous_cell_carcinoma_-_a1_--_high_mag.jpg | |||
| Width = | |||
| Caption = Esophageal squamous cell carcinoma. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = atypical squamous cells invading into the lamina propria | |||
| Subtypes = | |||
| LMDDx = [[squamous dysplasia of the esophagus]] | |||
| Stains = | |||
| IHC = p63 +'ve, CK5/6 +'ve | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[esophagus]] - usually proximal or mid portion | |||
| Assdx = [[squamous dysplasia of the esophagus]], [[alcohol]], [[smoking]] | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = dysphagia of solid and liquids | |||
| Prevalence = uncommon | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = poor | |||
| Other = | |||
| ClinDDx = benign [[esophageal stricture]] | |||
| Tx = usu. surgery - if feasible, chemotherapy, radiation | |||
}} | |||
'''Squamous cell carcinoma of the esophagus''' is a relatively uncommon form of esophageal cancer. | |||
It is also known as '''esophageal squamous cell carcinoma''', abbreviated '''esophageal SCC'''. | |||
''Squamous cell carcinoma'', also ''squamous carcinoma'', is discussed in general terms in the ''[[squamous cell carcinoma]]'' article. | |||
==General== | |||
*Like squamous cell carcinoma elsewhere. | |||
Risk factors:<ref name=Ref_APBR104>{{Ref APBR|104 Q1}}</ref> | |||
*[[Ethanol abuse|Alcohol consumption]]. | |||
*[[Smoking|Tobacco use]]. | |||
*Food with nitrosamines. | |||
*Burning-hot beverages. | |||
**Disputed.<ref>{{Cite journal | last1 = Zamora-Ros | first1 = R. | last2 = Luján-Barroso | first2 = L. | last3 = Bueno-de-Mesquita | first3 = HB. | last4 = Dik | first4 = VK. | last5 = Boeing | first5 = H. | last6 = Steffen | first6 = A. | last7 = Tjønneland | first7 = A. | last8 = Olsen | first8 = A. | last9 = Bech | first9 = BH. | title = Tea and coffee consumption and risk of esophageal cancer: the European Prospective Investigation into Cancer and Nutrition (EPIC) study. | journal = Int J Cancer | volume = | issue = | pages = | month = Feb | year = 2014 | doi = 10.1002/ijc.28789 | PMID = 24535727 }}</ref> | |||
Note: | |||
*Reflux is ''not'' a risk factor for esophageal SCC. | |||
**It is a risk factor indirectly for [[esophageal adenocarcinoma]]. | |||
Clinical: | |||
*Dysphagia of solid and liquids. | |||
*Weight loss. | |||
*Multimodal treatment - surgery, chemotherapy and radiation.<ref name=pmid24480403>{{Cite journal | last1 = Bass | first1 = GA. | last2 = Furlong | first2 = H. | last3 = O'Sullivan | first3 = KE. | last4 = Hennessy | first4 = TP. | last5 = Walsh | first5 = TN. | title = Chemoradiotherapy, with adjuvant surgery for local control, confers a durable survival advantage in adenocarcinoma and squamous cell carcinoma of the oesophagus. | journal = Eur J Cancer | volume = | issue = | pages = | month = Jan | year = 2014 | doi = 10.1016/j.ejca.2013.12.022 | PMID = 24480403 }}</ref> | |||
==Gross== | |||
*Mass in the esophagus - classically proximal or mid portion. | |||
==Microscopic== | |||
Features - atypical squamous cells with invasion through the basement membrane: | |||
*Cytology: | |||
**Nucleus - typical central. | |||
***+/-Mitoses. | |||
**Cytoplasm - "dense-appearing", typically eosinophilic (may be intensely eosinophilic). | |||
*+/-Squamous whorls. | |||
Note: | |||
*Just to make things confusing, the ''Staging'' of early SCC differs from that of early adenocarcinoma! | |||
DDx: | |||
*Reactive changes. | |||
*[[Squamous dysplasia of the esophagus]]. | |||
*[[Adenocarcinoma of the esophagus]]. | |||
*[[metastasis|Metastatic]] carcinoma. | |||
===Images=== | |||
<gallery> | |||
Image: Esophageal squamous cell carcinoma -- intermed mag.jpg | Esophageal SCC - intermed. mag. | |||
Image: Esophageal squamous cell carcinoma -- high mag.jpg | Esophageal SCC - high mag. | |||
Image: Esophageal squamous cell carcinoma -- very high mag.jpg | Esophageal SCC - very high mag. | |||
</gallery> | |||
<gallery> | |||
Image: Esophageal squamous cell carcinoma - a1 -- high mag.jpg | Esophageal SCC - high mag. | |||
Image: Esophageal squamous cell carcinoma - a2 -- high mag.jpg | Esophageal SCC - high mag. | |||
Image: Esophageal squamous cell carcinoma - a3 -- high mag.jpg | Esophageal SCC - high mag. | |||
Image: Esophageal squamous cell carcinoma - a1 -- very high mag.jpg | Esophageal SCC - very high mag. | |||
</gallery> | |||
www: | |||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544238/figure/fig08/ Carcinoma in situ (nih.gov)].<ref name=pmid23330004>{{Cite journal | last1 = Terada | first1 = T. | title = A clinicopathologic study of esophageal 860 benign and malignant lesions in 910 cases of consecutive esophageal biopsies. | journal = Int J Clin Exp Pathol | volume = 6 | issue = 2 | pages = 191-8 | month = | year = 2013 | doi = | PMID = 23330004 }}</ref> | |||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544238/figure/fig09/ Squamous cell carcinoma of the esophagus (nih.gov)]. | |||
==Sign out== | |||
<pre> | |||
ESOPHAGUS, BIOPSY: | |||
- INVASIVE SQUAMOUS CELL CARCINOMA, KERATINIZING, MODERATELY DIFFERENTIATED. | |||
COMMENT: | |||
Benign squamous epithelium at least partially overlies the invasive squamous | |||
cell carcinoma; this may mask the true extent of the lesion on endoscopy. | |||
</pre> | |||
===Micro=== | |||
The sections show a squamous mucosa with focal moderate atypia of the squamous cells, | |||
keratinization and easily identified mitotic figures. The atypical cells are partially | |||
covered by benign squamous cells, and there is a very sharp transition between the cells | |||
with atypia and those without. The atypical squamous cells extend into the subepithelial tissue in irregularly shaped nests and cords. A small amount of benign muscle is present. | |||
==See also== | |||
*[[Esophagus]]. | |||
*[[Squamous cell carcinoma]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Esophagus]] | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] |
Latest revision as of 16:54, 28 October 2021
Squamous cell carcinoma of the esophagus is a relatively uncommon form of esophageal cancer.
Squamous cell carcinoma of the esophagus | |
---|---|
Diagnosis in short | |
Esophageal squamous cell carcinoma. H&E stain. | |
| |
LM | atypical squamous cells invading into the lamina propria |
LM DDx | squamous dysplasia of the esophagus |
IHC | p63 +'ve, CK5/6 +'ve |
Site | esophagus - usually proximal or mid portion |
| |
Associated Dx | squamous dysplasia of the esophagus, alcohol, smoking |
Symptoms | dysphagia of solid and liquids |
Prevalence | uncommon |
Prognosis | poor |
Clin. DDx | benign esophageal stricture |
Treatment | usu. surgery - if feasible, chemotherapy, radiation |
It is also known as esophageal squamous cell carcinoma, abbreviated esophageal SCC.
Squamous cell carcinoma, also squamous carcinoma, is discussed in general terms in the squamous cell carcinoma article.
General
- Like squamous cell carcinoma elsewhere.
Risk factors:[1]
- Alcohol consumption.
- Tobacco use.
- Food with nitrosamines.
- Burning-hot beverages.
- Disputed.[2]
Note:
- Reflux is not a risk factor for esophageal SCC.
- It is a risk factor indirectly for esophageal adenocarcinoma.
Clinical:
- Dysphagia of solid and liquids.
- Weight loss.
- Multimodal treatment - surgery, chemotherapy and radiation.[3]
Gross
- Mass in the esophagus - classically proximal or mid portion.
Microscopic
Features - atypical squamous cells with invasion through the basement membrane:
- Cytology:
- Nucleus - typical central.
- +/-Mitoses.
- Cytoplasm - "dense-appearing", typically eosinophilic (may be intensely eosinophilic).
- Nucleus - typical central.
- +/-Squamous whorls.
Note:
- Just to make things confusing, the Staging of early SCC differs from that of early adenocarcinoma!
DDx:
- Reactive changes.
- Squamous dysplasia of the esophagus.
- Adenocarcinoma of the esophagus.
- Metastatic carcinoma.
Images
www:
Sign out
ESOPHAGUS, BIOPSY: - INVASIVE SQUAMOUS CELL CARCINOMA, KERATINIZING, MODERATELY DIFFERENTIATED. COMMENT: Benign squamous epithelium at least partially overlies the invasive squamous cell carcinoma; this may mask the true extent of the lesion on endoscopy.
Micro
The sections show a squamous mucosa with focal moderate atypia of the squamous cells, keratinization and easily identified mitotic figures. The atypical cells are partially covered by benign squamous cells, and there is a very sharp transition between the cells with atypia and those without. The atypical squamous cells extend into the subepithelial tissue in irregularly shaped nests and cords. A small amount of benign muscle is present.
See also
References
- ↑ Lefkowitch, Jay H. (2006). Anatomic Pathology Board Review (1st ed.). Saunders. pp. 104 Q1. ISBN 978-1416025887.
- ↑ Zamora-Ros, R.; Luján-Barroso, L.; Bueno-de-Mesquita, HB.; Dik, VK.; Boeing, H.; Steffen, A.; Tjønneland, A.; Olsen, A. et al. (Feb 2014). "Tea and coffee consumption and risk of esophageal cancer: the European Prospective Investigation into Cancer and Nutrition (EPIC) study.". Int J Cancer. doi:10.1002/ijc.28789. PMID 24535727.
- ↑ Bass, GA.; Furlong, H.; O'Sullivan, KE.; Hennessy, TP.; Walsh, TN. (Jan 2014). "Chemoradiotherapy, with adjuvant surgery for local control, confers a durable survival advantage in adenocarcinoma and squamous cell carcinoma of the oesophagus.". Eur J Cancer. doi:10.1016/j.ejca.2013.12.022. PMID 24480403.
- ↑ Terada, T. (2013). "A clinicopathologic study of esophageal 860 benign and malignant lesions in 910 cases of consecutive esophageal biopsies.". Int J Clin Exp Pathol 6 (2): 191-8. PMID 23330004.