Pathology pathogenesis esophageal cancer

Squamous cell carcinoma

Squamous cell carcinomas (SCCs) are usually located in the proximal or mid third of the esophagus.

Submucosal invasion at an early stage is common.

An area of chronic epithelial irritation or injury may be the etiology of an infiltrating and/or ulcerated mass.

As the draining lymphatics are located relatively superficially in the lamina propria (in contrast to the deeper muscularis mucosa), early local lymph node invasion is frequent.

30% percent of patients have distant metastases at presentation.

Adenocarcinomas

Adenocarcinomas are most commonly located in the GEJ or distal third of the esophagus.

They often develop in or are associated with Barrett’s metaplasia, which is a condition in which the columnar mucosa of the distal esophagus develops squamous metaplastic changes in response to chronic reflux.

The pattern of lymphatic and metastatic spread is similar to that seen in SCC.