Rubio C A, Aberg B
Department of Pathology, Karolinska Hospital, Stockholm, Sweden.
Pathol Res Pract. 1991 Dec;187(8):1009-13. doi: 10.1016/S0344-0338(11)81073-3.
A total of 50 esophagi with carcinoma were reviewed for the presence of histological changes in the subepithelial tissues of the Barrett's mucosa. Those changes consisted in the thickening of the muscularis mucosae, the presence of muscle fibres in the lamina propria mucosae, fibrosis of the submucosa and sometimes total obliteration of the subepithelial tissues by collagen-rich sclerosis. Those changes have been connoted as "musculo-fibrous anomaly". Barrett's mucosa was present in all 18 specimens with adenocarcinoma and in 13 of the remaining 32 specimens with squamous cell carcinoma. Musculo-fibrous anomaly of the Barrett's mucosa occurred in all 18 specimens with adenocarcinoma and in 10 of the 13 specimens with a concomitantly growing squamous cell carcinoma. Esophageal and metaplastic glands were surrounded, compressed and deformed by the fibrotic tissue. The histological changes described explain the difficulties in the differential diagnosis--in biopsy specimens--between normal glands or glands with dysplastic changes "trapped" in the collagen-rich fibrotic tissue and true invasive adenocarcinoma of the Barrett's esophagus.
对50例食管癌标本进行检查，观察巴雷特黏膜上皮下组织的组织学变化。这些变化包括黏膜肌层增厚、黏膜固有层出现肌纤维、黏膜下层纤维化，有时上皮下组织被富含胶原的硬化完全闭塞。这些变化被称为“肌纤维异常”。在所有18例腺癌标本以及其余32例鳞状细胞癌标本中的13例中均发现有巴雷特黏膜。18例腺癌标本以及13例伴有鳞状细胞癌生长的标本中的10例均出现了巴雷特黏膜的肌纤维异常。食管腺和化生腺被纤维化组织包围、压迫并变形。上述组织学变化解释了在活检标本中，正常腺体或“被困”于富含胶原的纤维化组织中的发育异常腺体与巴雷特食管真正浸润性腺癌之间鉴别诊断困难的原因。
