A report on Esophageal cancer

Endoscopic image of an esophageal adenocarcinoma
Esophageal cancer (lower part) as a result of Barrettʼs esophagus
Esophageal cancer as shown by a filling defect during an upper GI series
Esophageal stent for esophageal cancer
Esophageal stent for esophageal cancer
Before and after a total esophagectomy
Typical scar lines after the two main methods of surgery
Death from esophageal cancer per million persons in 2012
Endoscopic image of Barrett esophagus – a frequent precursor of esophageal adenocarcinoma
Endoscopy and radial endoscopic ultrasound images of a submucosal tumor in the central portion of the esophagus
Contrast CT scan showing an esophageal tumor (axial view)
Contrast CT scan showing an esophageal tumor (coronal view)
Esophageal cancer
Micrograph showing histopathological appearance of an esophageal adenocarcinoma (dark blue – upper-left of image) and normal squamous epithelium (upper-right of image) at H&E staining
T1, T2, and T3 stages of esophageal cancer
Stage T4 esophageal cancer
Esophageal cancer with spread to lymph nodes
Internal radiotherapy for esophageal cancer
Self-expandable metallic stents are sometimes used for palliative care

Cancer arising from the esophagus—the food pipe that runs between the throat and the stomach.

- Esophageal cancer
Endoscopic image of an esophageal adenocarcinoma

32 related topics with Alpha

Overall

The digestive tract, with the esophagus marked in red

Esophagus

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Organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to the stomach.

Organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to the stomach.

The digestive tract, with the esophagus marked in red
The esophagus is constricted in three places.
A mass seen during an endoscopy and an ultrasound of the mass conducted during the endoscopy session.

The esophagus may be affected by gastric reflux, cancer, prominent dilated blood vessels called varices that can bleed heavily, tears, constrictions, and disorders of motility.

Endoscopic image of Barrett's esophagus, which is the area of dark reddish-brown mucosa at the base of the
                   esophagus. (Biopsies showed intestinal metaplasia.)

Barrett's esophagus

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Condition in which there is an abnormal change in the mucosal cells lining the lower portion of the esophagus, from stratified squamous epithelium to simple columnar epithelium with interspersed goblet cells that are normally present only in the small intestine and large intestine.

Condition in which there is an abnormal change in the mucosal cells lining the lower portion of the esophagus, from stratified squamous epithelium to simple columnar epithelium with interspersed goblet cells that are normally present only in the small intestine and large intestine.

Endoscopic image of Barrett's esophagus, which is the area of dark reddish-brown mucosa at the base of the
                   esophagus. (Biopsies showed intestinal metaplasia.)
Histopathology of Barrett's esophagus, showing intestinalized epithelium with goblet cells, as opposed to normal stratified squamous epithelium of the esophagus, and pseudostratified columnar epithelium of the fundus of the stomach. The submucosa displays an infiltrate including lymphocytes and plasma cells, constituting an underlying chronic inflammation. The area between the stratified and the intestinalized epithelium displays reactive changes, but there is no secondary dysplasia in this case. H&E stain.
In incomplete Barrett's esophagus, there are both foveolar cells and goblet cells, the latter (indicated by arrows) usually having a slightly bluish color compared to the apical cytoplasm of foveolar cells on H&E stain. An occasional but specific sign of goblet cells is crescent shaped nuclei (seen in middle one).
Micrograph showing Barrett's esophagus - columnar epithelia with goblet cells - on the left side of image; and normal stratified squamous epithelium on the right side of image Alcian blue stain
High-magnification micrograph of Barrett's esophagus showing the characteristic goblet cells, Alcian blue stain
Endoscopic view of Barrett's esophagus showing location of biopsies for screening using the Seattle protocol
Barrettʼs cancer adenocarcinoma (poor; signet-ringcell)

This change is considered to be a premalignant condition because it is associated with a high incidence of further transition to esophageal adenocarcinoma, an often-deadly cancer.

X-ray showing radiocontrast from the stomach (white material below diaphragm) entering the esophagus (three vertical collections of white material in the mid-line of the chest) due to severe reflux

Gastroesophageal reflux disease

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Chronic condition in which stomach contents and acid rise up into the esophagus, resulting in symptoms and/or complications.

Chronic condition in which stomach contents and acid rise up into the esophagus, resulting in symptoms and/or complications.

X-ray showing radiocontrast from the stomach (white material below diaphragm) entering the esophagus (three vertical collections of white material in the mid-line of the chest) due to severe reflux
Frontal view of severe tooth erosion in GERD.
Severe tooth erosion in GERD.
A comparison of a healthy condition to GERD
Endoscopic image of peptic stricture, or narrowing of the esophagus near the junction with the stomach: This is a complication of chronic gastroesophageal reflux disease and can be a cause of dysphagia or difficulty swallowing.

Esophageal adenocarcinoma – a form of cancer

A coronal CT scan showing a malignant mesothelioma
Legend: → tumor ←, ✱ central pleural effusion, 1 & 3 lungs, 2 spine, 4 ribs, 5 aorta, 6 spleen, 7 & 8 kidneys, 9 liver

Cancer

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Group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body.

Group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body.

A coronal CT scan showing a malignant mesothelioma
Legend: → tumor ←, ✱ central pleural effusion, 1 & 3 lungs, 2 spine, 4 ribs, 5 aorta, 6 spleen, 7 & 8 kidneys, 9 liver
Symptoms of cancer metastasis depend on the location of the tumor.
The GHS Hazard pictogram for carcinogenic substances
Share of cancer deaths attributed to tobacco in 2016.
The incidence of lung cancer is highly correlated with smoking.
Cancers are caused by a series of mutations. Each mutation alters the behavior of the cell somewhat.
The central role of DNA damage and epigenetic defects in DNA repair genes in carcinogenesis
Chest X-ray showing lung cancer in the left lung
Three measures of global cancer mortality from 1990 to 2017
Engraving with two views of a Dutch woman who had a tumor removed from her neck in 1689
University of Florida Cancer Hospital
CancerTreeMammal
An invasive ductal carcinoma of the breast (pale area at the center) surrounded by spikes of whitish scar tissue and yellow fatty tissue
An invasive colorectal carcinoma (top center) in a colectomy specimen
A squamous-cell carcinoma (the whitish tumor) near the bronchi in a lung specimen
A large invasive ductal carcinoma in a mastectomy specimen

For example, mass effects from lung cancer can block the bronchus resulting in cough or pneumonia; esophageal cancer can cause narrowing of the esophagus, making it difficult or painful to swallow; and colorectal cancer may lead to narrowing or blockages in the bowel, affecting bowel habits.

Heartburn

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Burning sensation in the central chest or upper central abdomen.

Burning sensation in the central chest or upper central abdomen.

Esophageal cancers

A chest X-ray showing achalasia ( arrows point to the outline of the massively dilated esophagus )

Esophageal achalasia

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Failure of smooth muscle fibers to relax, which can cause the lower esophageal sphincter to remain closed.

Failure of smooth muscle fibers to relax, which can cause the lower esophageal sphincter to remain closed.

A chest X-ray showing achalasia ( arrows point to the outline of the massively dilated esophagus )
Transhiatal oesophagectomy specimen from a patient suffering from late-stage achalasia. Diverticulum at the left lower end of the oesophagus.
An axial CT image showing marked dilatation of the esophagus in a person with achalasia.
"Bird's beak" appearance and "megaesophagus", typical in achalasia.
Schematic of manometry in achalasia showing aperistaltic contractions, increased intraesophageal pressure, and failure of relaxation of the lower esophageal sphincter.
Image of a stomach which has undergone Fundoplomy

However, a small proportion occurs secondary to other conditions, such as esophageal cancer, Chagas disease (an infectious disease common in South America) or Triple-A syndrome.

The digestive tract, with the esophagus marked in red

Dysphagia

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Difficulty in swallowing.

Difficulty in swallowing.

The digestive tract, with the esophagus marked in red

Esophageal cancer

Micrograph of an adenocarcinoma showing mucin-containing vacuoles. Pap test

Adenocarcinoma

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Type of cancerous tumor that can occur in several parts of the body.

Type of cancerous tumor that can occur in several parts of the body.

Micrograph of an adenocarcinoma showing mucin-containing vacuoles. Pap test
Many seborrheic keratoses on back of person with Leser–Trélat sign due to colon cancer
Gross appearance of an opened colectomy specimen containing two adenomatous polyps (the brownish oval tumors above the labels, attached to the normal beige lining by a stalk) and one invasive colorectal carcinoma (the crater-like, reddish, irregularly-shaped tumor located above the label)
Histopathologic image of colonic carcinoid stained by hematoxylin and eosin
Pie chart showing incidence of adenocarcinoma of the lung (shown in yellow) as compared to other lung cancer types, with fractions of non-smokers versus smokers shown for each type

Thus invasive ductal carcinoma, the most common form of breast cancer, is adenocarcinoma but does not use the term in its name—however, esophageal adenocarcinoma does to distinguish it from the other common type of esophageal cancer, esophageal squamous cell carcinoma.

Main histopathology features of squamous-cell carcinoma.

Squamous cell carcinoma

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Squamous-cell carcinomas (SCCs), also known as epidermoid carcinomas, comprise a number of different types of cancer that begin in squamous cells.

Squamous-cell carcinomas (SCCs), also known as epidermoid carcinomas, comprise a number of different types of cancer that begin in squamous cells.

Main histopathology features of squamous-cell carcinoma.
A large head and neck squamous-cell carcinoma of the tongue as seen on CT imaging
Photograph of a squamous cell carcinoma: Tumour is on the left, obstructing the bronchus (lung), beyond the tumour, the bronchus is inflamed and contains mucus.
Biopsy of a highly differentiated squamous cell carcinoma of the mouth. Typical squamous-cell carcinoma cells are large with abundant eosinophilic cytoplasm and large, often vesicular, nuclei. Haematoxylin & eosin stain
Squamous Cell Carcinoma, well differentiated, left upper paraspinal back marked for biopsy with adjacent actinic keratosis
thumb|Squamous Cell Carcinoma, left lateral canthus marked for biopsy
thumb|Squamous Cell Carcinoma, left ventral forearm
Adenoid squamous-cell carcinoma
Basaloid squamous-cell carcinoma
Clear-cell squamous-cell carcinoma
Spindle-cell squamous-cell carcinoma

Esophageal squamous-cell carcinoma: A type of esophageal cancer

Angular stomatitis

Plummer–Vinson syndrome

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Rare disease characterized by difficulty swallowing, iron-deficiency anemia, glossitis, cheilosis and esophageal webs.

Rare disease characterized by difficulty swallowing, iron-deficiency anemia, glossitis, cheilosis and esophageal webs.

Angular stomatitis
Upright double contrast image showing jet phenomennna from cervical esophageal web.
Right posterior oblique prone single contrast flouroscopic last image hold image showing circumferential thin cervical esophageal web.
Ascorbic-acid

Its identification and follow-up is considered relevant due to increased risk of squamous cell carcinomas of the esophagus and pharynx.