2. Esophageal carcinoma

Organ: Oesophagus

Not the best picture and not the best preparation. You can vaguely see where the normal mucosa stops and the abnormal mucosa starts.

Description:

We can see that the mucosa of the oesophagus is normal, except on the lower part. On that part is the mucosa ulcerated.

Diagnosis: Probably oesophageal adenocarcinoma, unlikely oesophageal squamous cell carcinoma

Risk factors:

• Oesophageal adenocarcinoma
  • Barret’s metaplasia (gastro-oesophageal reflux disease)
• Oesophageal squamous cell carcinoma
  • Smoking
  • Alcohol
  • Poor hygiene

Theory:

Two major types of oesophageal cancer exist according to microscopy: squamous cell carcinoma and adenocarcinoma.

Oesophageal adenocarcinoma mostly affects the lower parts, which is why this preparation is most likely an adenocarcinoma. The major risk factor is gastro-oesophageal reflux disease, which again is associated with obesity, which has become more common the last decades.

Oesophageal cancer is also classified according to the macroscopy; we can have polypoid types or ulcerating types.

Polypoid tumors produce “polyps” that protrude into the lumen and obstruct it. It is the most common type.

Ulcerating tumors don’t protrude into the lumen but ulcerates the mucosal surface. This may cause melena. This preparation is of this type.