What common esophageal diseases should be differentiated from esophageal cancer?

Esophageal cancer should be differentiated from the following diseases:

(1) Esophageal achalasia: The patients are relatively young, mostly women, with a long course of disease and difficulty swallowing. The disease often occurs intermittently. Barium X-ray shows that the lower end of the esophagus is smooth and bird-beak-like.

(2) Benign esophageal stricture: It is usually caused by accidental ingestion of fish acid, strong alkali, recurrent reflux esophagitis, foreign body damage to food, or esophageal or gastric surgery. Careful medical history and esophagoscopy can be used for identification.

(3) Reflux esophagitis: The main symptoms are burning pain or pain behind the sternum, sometimes accompanied by difficulty swallowing. Esophagoscopy can reveal mucosal inflammation, erosion or ulcers.

(4) Other benign diseases of the pharynx and esophagus: such as chronic pharyngitis (called "plum pit qi" in traditional Chinese medicine), esophageal diverticulum, esophageal polyps, and esophageal tuberculosis, all of which have symptoms similar to esophageal cancer. Their differentiation mainly relies on esophagoscopy and esophageal barium swallow.

(5) Benign esophageal tumors: mainly include leiomyoma, esophageal polyps, esophageal papilloma, and esophageal granular cell myoblastoma. Their differentiation mainly relies on X-ray examination, esophagoscopy and pathological biopsy.

(6) Esophageal malignant tumors: such as esophageal sarcoma, esophageal carcinosarcoma, esophageal melanoma, esophageal malignant lymphoma, etc., diagnosis must be confirmed by pathological biopsy.

(7) Cardiac spasm: It is more common in young female patients, with symptoms of difficulty swallowing that recur for many years. Barium swallow examination shows that the stenosis outside the cardia is funnel-shaped.