Esophageal cancer pathophysiology: Difference between revisions

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Atypical squamous cells with invasion through the basement membrane:
Atypical squamous cells with invasion through the basement membrane:
*Cytology:
*Cytology:
**Nucleus - typical central
**Nucleus - typically central
**Mitoses may be present
**Mitotic activity
**Cytoplasm - "dense-appearing", typically eosinophilic (may be intensely eosinophilic)
**Cytoplasm - "dense-appearing", typically eosinophilic (may be intensely eosinophilic)
*Squamous whorls may be present<ref>{{Cite web | title =Squamous cell carcinoma of the esophagus
**Squamous whorls may be present<ref>{{Cite web | title =Squamous cell carcinoma of the esophagus
  | url =http://librepathology.org/wiki/index.php/Squamous_cell_carcinoma_of_the_esophagus }}</ref>
  | url =http://librepathology.org/wiki/index.php/Squamous_cell_carcinoma_of_the_esophagus }}</ref>



Revision as of 14:41, 6 December 2017

Esophageal cancer Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Overview

The pathophysiology of esophageal cancer depends on the histological subtype.

Pathophysiology

The esophagus is lined by nonkeratinized stratified squamous epithelium. This lining is maintained as long as there are no stressors leading to a metaplastic change. These stressors may include genetic factors, chronic alcoholism, smoking, ingesting spicy foods and hot liquids frequently, and chronic gastroesophageal reflux. Over time a dysplastic change occurs followed by a metaplastic change which may be of the squamous cell or adenocarcinoma type.[1]

Pathology

Microscopic pathology

Squamous cell carcinoma

Atypical squamous cells with invasion through the basement membrane:

  • Cytology:
    • Nucleus - typically central
    • Mitotic activity
    • Cytoplasm - "dense-appearing", typically eosinophilic (may be intensely eosinophilic)
    • Squamous whorls may be present[2]
Esophageal squamous cell carcinoma by Nephron - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=31284085

Adenocarcinoma[3]

  • Invading cell clusters or glands
  • Cribriforming (more than rare) or desmoplasia or "deep" invasion (into submucosa)
  • Nuclear atypia of malignancy:
  • Size variation
  • Shape variation
  • Staining variation
  • Mitoses (common)
Esophageal adenocarcinoma by Nephron - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=12475495

References

  1. Quante M, Graham TA, Jansen M (2017). "Insights into the Pathophysiology of Esophageal Adenocarcinoma". Gastroenterology. doi:10.1053/j.gastro.2017.09.046. PMID 29037468.
  2. "Squamous cell carcinoma of the esophagus".
  3. "Esophageal adenocarcinoma".


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