Four types of early esophageal cancer

The symptoms of early esophageal cancer patients are not obvious or are mild. Early cases can only be found through cytological screening in areas with a high incidence of esophageal cancer. Most lesions are limited to the mucosal surface, and no obvious masses can be seen. Therefore, when the early and middle and late esophageal cancers are classified by the naked eye, they are different. Early esophageal cancer is generally divided into the following four types:

1. Nipple type

The tumor is a distinct nodular protrusion, and the esophageal mucosa at the lesion is papillary or mushroom-shaped and protrudes into the esophageal cavity. The diameter is 1 to 3 cm, and it is clearly demarcated from the surrounding normal mucosa. The surface is generally smooth, with small erosions, sometimes covered with grayish-yellow inflammatory secretions, and occasionally erosions. Microscopically, most of them are early invasive cancers.

2. Latent type

The esophageal mucosa at the lesion is flush with the surrounding normal esophageal mucosa. In fresh specimens, the mucosa at the lesion is darker than normal, pink, and the capillaries in the mucosa are dilated and congested, showing mild congestion spots or thickening of mucosal folds, which are all carcinoma in situ under the microscope. This type is the earliest manifestation of esophageal cancer and is easily missed during endoscopic examination.

3. Plaque type

The esophageal mucosa at the lesion site is slightly swollen and raised, with a rough and uneven surface, darker gray and pale in color, and sometimes small erosion areas can be seen. The lesion has clear boundaries and sometimes involves the entire esophagus. The folds of the esophageal mucosa are thickened, disordered and interrupted, and the mucosal surface is rough, showing granules of varying sizes and psoriasis-like appearance. This type of carcinoma in situ accounts for 1/3, and early invasive carcinoma accounts for 2/3.

4. Erosive type

The esophageal mucosa at the lesion site is slightly sunken or slightly eroded. The eroded area is darker in color, with irregular edges in a map-like shape, and is clearly demarcated from the surrounding normal mucosa. The eroded area is finely granular, with occasional residual normal mucosal islands. Except for a few cases covered with fibrinous pseudomembranes, most erosion surfaces are relatively clean, with half of the cases being carcinoma in situ and half being early invasive carcinoma under the microscope.