Histopathological Diagnosis of Esophageal Squamous Dysplasia in Biopsy Specimens Yasuo Ohkura 1 1Department of Pathology, Kyorin University School of Medicine, Tokyo Keyword: 食道扁平上皮 , dysplasia , 生検診断 , 見直し診断 , 良悪性の判定 pp.137-145
Published Date 2007/2/25
DOI https://doi.org/10.11477/mf.1403100944
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 Sixty-five esophageal biopsy specimens, diagnosed as dysplasia from 1999 to 2005 in Kyorin University School of Medicine, were re-examined. Biopsy specimens were diagnosed by fourteen general pathologists. The diagnoses were 24 specimens(37%)of mild dysplasia, 6 specimens(9%)of moderate dysplasia, 14 specimens (22%)of severe dysplasia and 21 specimens(32%)of dysplasia alone without grading. After re-examination 27 specimens(42%)are esophagitis, 1 specimen(2%)is moderate dysplasia, 7 specimens(11%)are severe dysplasia and 30 specimens(46%)are squamous cell carcinoma(SCC). Most of the specimens are diagnosed as esophagitis without atypia and SCC. Cases of dysplasia are not so many, and its characteristic histological figure located at the line of demarcation between atypical epithelium and normal epithelium is not well defined. Pathologists easily use the word "dysplasia" in accord with information of past history of therapy such as EMR, radiation and chemotherapy. Most mild and moderate dysplasia in previous diagnosis is re-diagnosed as espohagitis, and most severe dysplasia is re-diagnosed as SCC. However, five specimens(21%)of mild dysplasia in previous diagnosis and 2 specimens(33%)of moderate dysplasia are re-diagnosed as SCC. Histological figures of those specimens showed slight enlargement of nucleori, slight increase of nucleo-cytoplasmic ratio and slight loss of polarity, which factor are found in the lower part of the epithelium. Pathologists should know those figures thoroughly in diagnosing atypical esophageal epithelium. From the above results it can be seen that pathologist diagnose atypical esophageal epithelium as esophagitis or SCC at first, and then the borderline lesion between them is divided into two categories which are the indefinite lesion which cannot be diagnosed as benign or malignant and the malignant lesion suspected to be carcinoma.

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