Tamura Hiromi, Saiki Hirotsugu, Amano Takahiro, Yamamoto Masashi, Hayashi Shiro, Ando Hiroka, Doi Reiko, Nishida Tsutomu, Yamamoto Katsumi, Adachi Shiro
Hiromi Tamura, Hiroka Ando, Reiko Doi, Shiro Adachi, Department of Pathology, City Hospital of Toyonaka, Osaka 560-8565, Japan.
World J Gastroenterol. 2017 Jun 7;23(21):3928-3933. doi: 10.3748/wjg.v23.i21.3928.
A case of esophageal carcinoma exclusively composed of adenocarcinoma simulating an esophageal gland duct in a 61-year-old man is presented. The tumor arose as a slightly elevated lesion in the middle intrathoracic esophagus. It was almost completely overlaid with non-neoplastic stratified squamous epithelial cells. Beneath the overlying surface epithelium, an adenocarcinoma that was bilayered in structure diffusely invaded both the mucosal and submucosal layers. Although the tumor consisted exclusively of adenocarcinomatous cells, a keratinizing squamous cell carcinoma component was focally observed. The invasive carcinoma was focally continuous with the small area of the surface squamous epithelial layer, which was confirmed to be neoplastic by immunohistochemistry. Morphological and immunohistochemical examinations suggested that the adenocarcinomatous component arose from the esophageal surface epithelium and clearly differentiated into an esophageal gland duct. It is important to consider the possibility of this type of adenocarcinoma when diagnosing a ductal or glandular lesion of the esophagus in small biopsy specimens.
本文报告一例61岁男性食管腺癌病例，该肿瘤仅由模拟食管腺管的腺癌组成。肿瘤发生于胸段食管中段，表现为轻度隆起病变。肿瘤几乎完全被非肿瘤性复层鳞状上皮细胞覆盖。在上覆表面上皮下方，结构为双层的腺癌弥漫性侵犯黏膜层和黏膜下层。尽管肿瘤仅由腺癌细胞组成，但局部可见角化性鳞状细胞癌成分。浸润性癌与表面鳞状上皮层的小区域局部连续，免疫组化证实该区域为肿瘤性。形态学和免疫组化检查提示，腺癌成分起源于食管表面上皮，并明显分化为食管腺管。在小活检标本中诊断食管导管或腺性病变时，考虑这种类型腺癌的可能性很重要。
