Pathomorphology of advanced esophageal cancer

By | March 24, 2012

In advanced esophageal cancer in endoscopic features: the cancer has penetrated the submucosa, or esophageal full-thickness myometrial invasion, and even invaded the surrounding tissue, there are varying degrees of lymph node metastases. At present, will generally be divided into five types of advanced esophageal cancer.
In the form of an advanced esophageal pathology. Medullary
The more common type, accounting for 58.5%, highly malignant. Clinically obvious difficulty swallowing. Neck meal examination showed filling defect, stricture, ulcer depth, ranging from Xin Ying, more severe mucosal damage. Visible tumor invasive growth to the lumen, often involving the perimeter of most or all of the esophagus, esophageal stricture was irregular, thickened esophageal wall invasion, the upper and lower edge of wavy ridges with the depth ranging from mucosal ulcerative, lesions often exceeds the length of 5cm, gray tumor section, such as brain-like, hard, homogeneous and compact. Penetrate the muscular layer of the esophagus often has been around the connective tissue. Microscopically, the film was massive cancer, differentiation, different for small or moderate amount of connective tissue separated, less interstitial inflammatory cells. This type of excision is low, after the poor, is not sensitive to radiotherapy. But in recent years with improved surgical techniques and in-depth understanding of esophageal cancer, the type of surgical resection rate greatly increased, and the results are greatly improved than before. Resection rate can not simply measured by lesion length, and should pay attention to the depth of lesion and the relationship with neighboring organs.
Pathological in advanced esophageal cancer 2. Dong umbrella
About 17%. Relatively long history, often mild dysphagia. Esophageal lead agent by the slow food display lock, partial filling defect was butterfly, edge, such as lip-like notch. Esophageal wall thickening is not obvious. Visible tumors were oval or circular, peripheral bulge in or out, clear boundaries, like the mushroom. Mainly to the cavity of tumor growth, less foreign invasion. The size of the tumor surface, ranging from more than a superficial ulcer, often involving the esophageal wall side. Microscopic tumor was a large sheet, with severe interstitial inflammatory cell response, less fibrous tissue. This type of surgery is high, a higher radiation sensitivity, a better prognosis.
Pathological in advanced esophageal cancer 3. Ulcer-type pain
About 11%. Dysphagia often not serious, but often the more obvious thoracodorsal pain, high incidence of perforation. Lead agent through more smooth, often irregular margin, a large deep ulcer. Visible tumor was a depression, a clear single ulcer edge, ulcer surface inflammatory exudate. Peripheral can be slightly elevated, deep ulcer, esophageal wall penetration, in-depth muscle, and some even have invaded the connective tissue around the esophagus. Lesion involving the esophageal circumference most part, do not take the whole week involving the esophagus, stenosis is not obvious, the tumor slice thin. Microscope, the body has more tumor cell infiltration and mild chronic inflammation of connective tissue proliferation. This type of surgical resection rate moderate, mainly based on whether the ulcer and the infiltration depth of the adjacent organs, and that it may be difficult to remove. The risk of radiation is perforated, should be vigilant.
Pathological in advanced esophageal cancer 4. Narrow type
About 8.5%. Dysphagia often obvious, lead agent lead through difficult meal examination, showing a short and serious heart-shaped to narrow lesion expansion was above the esophagus. Visible within the invasive tumor growth in the esophagus, more involving esophageal most or all of the perimeter to form a ring narrow, short lesions. Ill-defined tumor and normal tissue, esophageal mucosa showed concentric contraction, significantly narrowing the expansion of the upper esophagus. Compact tumor cut surface structure, organization hard and full of connective tissue proliferation. Invasion of esophageal cancer and more muscular, and sometimes through the whole layer of the esophagus. Microscope, tumor tissue showed cord-like, surrounded by a large number of fibrous tissue and infiltration of connective tissue around the esophagus. The more serious type of foreign invasion, resection rate, radiation therapy is ineffective.
Advanced esophageal cancer in the pathological 5. Intracavity type
About 5%. Often without serious symptoms of swallowing difficulties are often overlooked in patients with delayed treatment. Dayton meal examination see slightly blocked by leading agents, such as sausage-like filling defect, the Ministry of lesions on the lower edge of the more sharp. Gross tumor was large, sudden to the cavity wall is sometimes associated with visible pedunculated, tumor involving the esophageal circumference most part, common irregular tumor surface superficial ulcer or erosion areas, often without foreign invasion, surgical resection rate is high. Very sensitive to radiation, but, except in patients with early, the long-term effect is still not very satisfactory.

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