Squamous cell carcinoma of the esophagus
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
Esophageal SCC - intermed. mag.
Esophageal SCC - high mag.
Esophageal SCC - very high mag.
Esophageal SCC - high mag.
Esophageal SCC - high mag.
Esophageal SCC - high mag.
Esophageal SCC - very high mag.
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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.