Differential diagnosis of esophageal cancer

By | April 3, 2012

Should pay attention to the differential diagnosis of esophageal cancer and chronic esophagitis, esophageal stenosis, severe esophageal like room, esophageal tuberculosis and differentiated from benign esophageal tumors. Before diagnosis should be asked in detail about the history, physical examination, and esophagus by means of X-lock meal examination, esophageal netting, esophagoscopy and other tests to be identified.
1. Functional difficulties apricot throat
Prevalent in the esophagus (select gate) lost flaccid disease, lower esophageal sphincter pressure, esophageal peristalsis weakness. The severity of dysphagia turn, also known as twin recover from illness responsible for the door. Functional esophageal recover from illness twin intermittent dysphagia, recover from illness with drugs effective solution. x ray imaging of esophageal and esophageal collar meal examination to exclude esophageal carcinoma. Temple esophageal cleft is due to neuromuscular disorders, to have been located in the chest under the bottom of the lower esophageal and gastric esophageal mediastinal shift in leap muscle above the hole, but do not have chest men Tong Shu, fullness after eating, swallowing unfavorable Dayton meal by X-esophageal imaging can be confirmed.
2. Esophageal dysphagia external pressure
Esophageal cancer diagnosis, is part of the esophagus adjacent organs of congenital abnormalities, dysphagia caused by esophageal compression. Common with aortic aneurysm, ectopic left subclavian artery, double aortic arch, intrathoracic thyroid, mediastinal tumor, mediastinal lymph node enlargement, aortic arch flexion extension. Esophageal pressure of swallowing difficulties of X-ray examination showed a mass corresponding parts. X-lock meal examination showed esophageal mucosa finishing, showing filling defect external pressure.
3. Esophagitis
Eating too rough to overheating and a lack of trace elements in tobacco and alcohol cause irritation or esophageal epithelial injury, can appear similar to the symptoms of early esophageal cancer, x ray film shows esophageal mucosa lock coarse meal, interruption, microscopic examination of esophageal mucosa shows edema, congestive cytology is the main means of identification, smear shows inflammatory cells.
4. Esophageal stenosis esophageal diverticulum end
Mostly benign esophageal stricture caused by ingestion of corrosive chemicals epilepsy marks narrow. The wall of the esophagus Shu room for food and the formation of the limitations of bulging or traction, more common in the elderly, longer duration, expressed as foreign body sensation in the throat, swallowing a sense of stagnation, often out of undigested food back, I am afraid there is room full of food stay, can cause fermentation and bad breath. Accompanied by inflammation, x ray imaging of esophageal and esophageal microscopy lock meal can be diagnosed with esophageal cancer can be a regret room, and some reports.
5. Esophageal tuberculosis
Differential diagnosis of esophageal cancer, esophageal tuberculosis rare, may be primary in the esophagus or other organs secondary to disseminated tuberculosis, x ray lead esophagus and esophageal cancer similar meal examination, there have difficulty swallowing, chest pain and other symptoms, esophagoscopy, biopsy, no cancer smear, Mycobacterium tuberculosis test was positive, sputum culture with Mycobacterium tuberculosis. Effective method for the identification of anti-tuberculosis treatment.
6. Esophageal benign tumor
(1) smooth muscle tumors: The most common disease of the long, slow development can occur in the esophagus of each segment, mostly single, round-shaped oval form. Usually asymptomatic or mild symptoms, tumor increases to some extent the adverse thoracodorsal pain when swallowing. x-ray film shows a half-moon of the filling defects, mucosal finishing, wrinkle men should flatten or disappear. Microscopic examination of esophageal mucosa outside the tumor can be seen sliding, such as when suspected leiomyoma generally do not do biopsy, so as not to damage mucous membrane, hinders surgical removal.
(2) esophageal polyps: incidence second only to the smooth muscle tumor, accounting for second place. Occur in the cervical esophagus, originated in the lower esophageal mucosa, polyps can be formed along the pedicle mass, broke into the esophageal lumen, the normal esophageal mucosa surface, there may be a long time to dysphagia. x ray imaging of esophageal and esophageal collar meal examination can help identify. There were occasional malignant esophageal polyp.
(3) the differential diagnosis of esophageal cancer, esophageal other benign: esophageal papilloma esophageal hemangioma, neurofibroma esophagus and esophageal adenocarcinoma, esophageal granular cell tumor and esophageal myoblasts and other inflammatory pseudotumor of the esophagus through the microscope can confirmed.

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