Stomach and Intestine(Tokyo) Volume 54, Issue 3 (March 2019)

Basic Histopathological Knowledge Required to Perform Magnifying Endoscopy in Patients with Pharyngeal and Esophageal Cancers Hiroshi Kawachi 1 , Kaoru Nakano 2 , Yohei Ikenoyama 2 , Yukiko Sato 1 , Akiyoshi Ishiyama 2 , Toshiyuki Yoshio 2 , Junko Fujisaki 2 1Departments of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 2Departments of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo Keyword: 食道 , 咽頭 , 扁平上皮癌 , Barrett食道 , 腺癌 , 血管 pp.308-319
Published Date 2019/3/25
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 Herein we describe the histopathological knowledge necessary for use of magnifying endoscopy in the pharynx and esophagus. In squamous cell carcinoma in situ, alteration of capillary vessels in the papilla plays a major role, whereas there are minimal changes of subepithelial capillary vessels. However, with deeper invasion, exfoliation of the intraepithelial component due to erosion and degeneration can obscure observation of capillary vessels in the papilla. Alternatively, irregularly-shaped vessels derived from subepithelial capillary vessels may appear on the surface of the tumor. Tumors with deeper submucosal invasion may exhibit surface desmoplasia(including fibroblastic and vascular proliferation). In these tumors, surface vessels of various diameters are often observed. In patients with Barrett's esophagus, endoscopic diagnosis difficulties may be due to irregularities of background columnar-lined mucosa, higher frequency of adenocarcinoma with low-grade architectural atypia, and tumor components covered with non-neoplastic epithelium.

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54巻3号 (2019年3月)
電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院