Difference between revisions of "Squamous cell carcinoma of the esophagus"
(5 intermediate revisions by the same user not shown) | |||
Line 1: | Line 1: | ||
{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = | | Image = Esophageal_squamous_cell_carcinoma_-_a1_--_high_mag.jpg | ||
| Width = | | Width = | ||
| Caption = | | Caption = Esophageal squamous cell carcinoma. [[H&E stain]]. | ||
| Synonyms = | | Synonyms = | ||
| Micro = atypical cells | | Micro = atypical squamous cells invading into the lamina propria | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[ | | LMDDx = [[squamous dysplasia of the esophagus]] | ||
| Stains = CK5/6 +ve | | Stains = | ||
| IHC = p63 +'ve, CK5/6 +'ve | |||
| EM = | | EM = | ||
| Molecular = | | Molecular = | ||
Line 15: | Line 15: | ||
| Gross = | | Gross = | ||
| Grossing = | | Grossing = | ||
| Site = [[esophagus]] - proximal or mid portion | | Site = [[esophagus]] - usually proximal or mid portion | ||
| Assdx = | | Assdx = [[squamous dysplasia of the esophagus]], [[alcohol]], [[smoking]] | ||
| Syndromes = | | Syndromes = | ||
| Clinicalhx = | | Clinicalhx = | ||
| Signs = | | Signs = | ||
| Symptoms = | | Symptoms = dysphagia of solid and liquids | ||
| Prevalence = uncommon | | Prevalence = uncommon | ||
| Bloodwork = | | Bloodwork = | ||
Line 28: | Line 28: | ||
| Other = | | Other = | ||
| ClinDDx = benign [[esophageal stricture]] | | ClinDDx = benign [[esophageal stricture]] | ||
| Tx = usu. surgery - if feasible | | Tx = usu. surgery - if feasible, chemotherapy, radiation | ||
}} | }} | ||
'''Squamous cell carcinoma of the esophagus''' is a relatively uncommon form of esophageal cancer. | '''Squamous cell carcinoma of the esophagus''' is a relatively uncommon form of esophageal cancer. | ||
Line 49: | Line 49: | ||
*Reflux is ''not'' a risk factor for esophageal SCC. | *Reflux is ''not'' a risk factor for esophageal SCC. | ||
**It is a risk factor indirectly for [[esophageal adenocarcinoma]]. | **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== | ==Gross== | ||
Line 54: | Line 59: | ||
==Microscopic== | ==Microscopic== | ||
Features - atypical squamous cells with | Features - atypical squamous cells with invasion through the basement membrane: | ||
*Cytology: | *Cytology: | ||
**Nucleus - typical central. | **Nucleus - typical central. | ||
Line 68: | Line 73: | ||
*[[Squamous dysplasia of the esophagus]]. | *[[Squamous dysplasia of the esophagus]]. | ||
*[[Adenocarcinoma of the esophagus]]. | *[[Adenocarcinoma of the esophagus]]. | ||
*[[metastasis|Metastatic]] carcinoma. | |||
===Images=== | ===Images=== |
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.