2. squamous cell carcinoma
what are the RFs for SCC of the esophagus? (5)
1. EtOH and tobacco
2. very hot tea (S. China and Iran)
3. Achalasia (Chagas in S America)
4. Esophageal web (e.g. Plummer Vinson syndrome)
5. esophageal injury (e.g. lye ingestion--chemical used to straighten hair)
does esophageal carcinoma have a poor or good prognosis?
presents late usually
what are some symptoms of esophageal carcinoma?
what are two symptoms for SCC, specifically?
1. progressive dysphagia, first solids, then liquids
2. weight loss
*SCC: hoarse voice (involvement of recurrent laryngeal nerve) and cough (trachea involvement)
location of LN spread depends on the level of the esophagus that is involved in esophageal carcinoma.
For each third of the esophagus, which LNs does the cancer like to spread to?
upper 1/3: cervical nodes
middle 1/3: tracheobronchial and mediastinal nodes
lower 1/3: gastric and celiac nodes
large, irregular ulcer with HEAPED UP margins;
most common involves the LESSER curvature of the antrum (similar to gastric ulcer)
intestinal gastric carcinoma;
most commonly involves the LESSER curvature of the antrum;
large, irregular ulcer with HEAPED UP margins
1. intestinal metaplasia (H. pylori or autoimmune gastritis)
2. nitrosamines in smoked foods (why there is a higher incidence in Japan)
3. blood type A
signet ring cells that diffusely infiltrate the gastric wall
diffuse gastric carcinoma;
signet ring cells: cancer cell where mucus pushes the nucleus off to the side;
diffusely infiltrate the entire gastric wall
1. Leser-Trelat (dozens of subhoerric dermatoses)
2. acanthosis nigricans
1. left supraclavicular node (Virchow node)
2. periumbilical region (Sister Mary Joseph nodule)
3. bilateral ovaries (Krukenberg tumor)
SMJ nodules: intestinal type
Krukenberg tumor: diffuse type (signet ring cells)