esophagus



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  • Normal

    • mucosa
      • nonkeratinizing squamous mucosa
      • lamina propria
      • muscularis mucosa
    • submucosa
    • muscularis propria
    • adventitia
    • signout
      • Benign squamous mucosa
      • No dysplasia, esophagitis or intestinal metaplasia identified

  • Approach

    • epithelial abnormalities
      • dysplasia/SIL
      • carcinoma
      • reflux changes, intestinal metaplasia
    • stromal infiltrate
      • soft tissue tumor
      • hematolymphoid
    • esophagitis
      • acute: candida
      • eosinophilic
    • clinical cues

  • Non-neoplastic

  • WHO neoplasms

  • TNM (useful for grossing)

    • Tis: in situ or high grade dysplasia
    • T1a: lamina propria or muscularis mucosa invasion
    • T1b: submucosa invasion
    • T2: muscularis propria invasion
    • T3: adventitia invasion
    • T4a: pleura, pericardium or diaphragm invasion
    • T4b: other adjacent structure invasion
    • N1: 1-2 regional nodes
    • N2: 3-6 regional nodes
    • N3: 7+ regional nodes

  • Staging

    • 0: Tis
    • IA: T1
    • IB: T2
    • IIA: T3
    • IIB: T1-2 N1
    • IIIA: T4a or T3 N1 or T1-2 N2
    • IIIB: T3 N2
    • IIIC: T4b or T4a N1-2 or N3
    • IV: M1
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