Pathological morphology of early esophageal cancer

Early esophageal cancer includes carcinoma in situ limited to the mucosa and early invasive cancer that invades the submucosal layer. The lesion ranges from 0.5 to 8 cm, and the size of the range is not necessarily proportional to the depth of tumor invasion and infiltration.

1. The color of the mucosa in flat lesions is darker than that in normal areas, and appears as mildly congested spots or thickened mucosal folds. Histologically, it is mostly carcinoma in situ.

2. Erosive type: The mucosa at the site of cancerous lesions is mildly eroded, with clear boundaries from the surrounding mucosa, presenting a map-like shape. The eroded area is dark red in color and granular in shape. Histology shows that the lesions are often limited to the mucosal lamina propria.

3. Plaque-type cancer: The esophageal mucosa is slightly raised, and there are plaques of varying sizes on the mucosal surface, showing psoriasis-like changes. The lesion is grayish white, and the longitudinal folds of the esophagus are interrupted, thickened or disordered. In the larger plaque lesions, multiple small superficial erosions can sometimes be seen. The mucosa at the cancerous site is obviously thickened when observed on the cross section. Most lesions are 2-4 cm, invading the muscularis mucosa and submucosa.

4. Papillary tumors are obvious nodular protrusions, small in size, mostly less than 3 cm, protruding into the lumen, with a clear boundary between the edge and the surrounding esophagus. Microscopically, they are basically early invasive cancers.