食管癌英文ContentAnatomyoftheEsophagusSummaryPathogeny(發病機制)ClinicalfeatureDiagnoseDifferentialdiagnosisExerciseAnatomyoftheEsophagusTheesophagusisamusculartube,whichisadigestiveorganbetweenthethroatandstomach.PhysiologicalstenosisofesophagusFirst:Thejunctionofthepharynx(咽)andesophagus.Second:locatedinthebackofleftprincipalbronchus.Third:Esophagealhiatus(食管裂孔).

3SectionsoftheesophagusTheuppersegmentThemiddlesegment

（Carcinomaoccurmostfrequent）

ThelowersegmentTrachealbifurcation(氣管分叉)SummaryCarcinomaoftheesophagusisacommonmalignanttumorthatoccursinapopulationcover40yearsold,andinpredilectionformale(好發于男性).PrevalenceandmortalityTherearemorethan300,000peopleworldwidediedfromesophagealcancereachyear,and150,000ofthemareChinese.nicheCavitylumpoccurred.AchalasiaofcardiaandesophagusNitrosamine(亞硝胺)廣泛侵犯食管全層,形成腔外腫物，管腔狹窄，表面可見潰瘍ThemiddlesegmentT1Wenhancescanningshowsalumpinthetracheaandbeenhancedlikethecarcinoma.DietaryhabitsAchalasiaofcardiaandesophagus(食管賁門失弛緩征)Small

nodules(小結節)ClinicalfeatureAnatomyoftheEsophagusPathogeny(發病機制)Classificationofesophageal

cancerPeripheral

organgotinvolved

or

lymphnodemetastasis.3SectionsoftheesophagusAchalasiaofcardiaandesophagusAnatomyoftheEsophagusPathogeny(發病機制)Pathogeny1.

Nitrosamine(亞硝胺)2.Fungus(真菌)3.Vitamindeficiency4.Dietaryhabits

NitrosamineNitrosamines

contentofthese

foods

areveryhighClinicalfeature

InearlystageSymptomsareoftennotobvious,butwhenswallowingthecoarsefood,differentdegreesofuncomfortablefeelingsmayoccur.（Carcinomaoccurmostfrequent）AnatomyoftheEsophagusConstrictivetypeEsophageal

wallcircularorirregularthickening(>5mm).protrudetype(隆起型)AnatomyoftheEsophagusCancerinvadethetracheaThemiddlesegmentProgressive

dysphagia

(進行性吞咽困難)Leiomyomaoftheesophagus(食管平滑肌瘤)Esophageal

wallcircularorirregularthickening(>5mm).Cachexia(惡病質)Nitrosamine（Carcinomaoccurmostfrequent）X-ray

barium

meal3SectionsoftheesophagusClassificationofesophageal

cancerClassificationofesophageal

cancerSmall

nodules(小結節)Pathogeny(發病機制)Loweresophagusbecomethinlikeabeak(鳥嘴征)ClinicalfeatureInthemiddleandadvancedstageProgressive

dysphagia

(進行性吞咽困難)Whenthetumor

invade

thetrachea,tracheoesophagealfistula(氣管食管瘺)Cachexia(惡病質)Classificationofesophageal

cancer1.Ulcerativetype(潰瘍型)2.Mushroomtype(蕈傘型)3.Constrictivetype(縮窄型)4.Medullarytype(髓質型)Diagnose1.X-ray

barium

meal2.ComputedTomography(CT)3.MagneticResonanceImaging(MR)1.X-ray

barium

meal(1).EarlystageEsophageal

mucosalfoldsbebeak(粘膜迂曲、斷裂)Singleor

multiplesmall

niches(龕影)Limitingfillingdefect(局限性充盈缺損)Bariumstream

slowor

temporary

residence(鋇劑流動緩慢或一過性滯留)PostoperationRecurSmall

nodules(小結節)protrudetype(隆起型)Early

ulcerativetypeEarlyconstrictivetype(2).Middleandadvancedstagea.Ulcerativetype(潰瘍型)

niche

Thesurroundingofthetumorbecomebulged,andthefoldsofmucousbecomedamaged.(周圍隆起,粘膜皺襞破壞)FillingdefectAnexpandoverthetumorb.MushroomtypenicheBeaded

fillingdefect(串珠樣充盈缺損)ComputedTomography(CT)Cavitylumpoccurred.Theesophagusisamusculartube,whichisadigestiveorganbetweenthethroatandstomach.DietaryhabitsX-ray

barium

mealAchalasiaofcardiaandesophagusX-ray

barium

mealWhenthetumor

invade

thetrachea,tracheoesophagealfistula(氣管食管瘺)ClinicalfeatureSmall

nodules(小結節)PostoperationThecarcinomacanencroachonthewhole-layerofesophagusandmakeastenosis,withulcerationonit.ThemiddlesegmentBeaded

fillingdefect(串珠樣充盈缺損)Pathogeny(發病機制)AnatomyoftheEsophagusEsophageal

wallcircularorirregularthickening(>5mm).Pathogeny(發病機制)AnexpandoverthetumorProgressive

dysphagia

(進行性吞咽困難)c.ConstrictivetypeM,63Y,Progressive

dysphagia

20dd.Medullarytype廣泛侵犯食管全層,形成腔外腫物，管腔狹窄，表面可見潰瘍Thecarcinomacanencroachonthewhole-layerofesophagus

andmakeastenosis,withulcerationonit.2.CT1.Esophageal

wallcircularorirregularthickening(>5mm).2.Cavitylumpoccurred.3.Paraesophageal

fatlayer

fuzzy,

disappear.4.Peripheral

organgotinvolved

or

lymphnodemetastasis.5.Enhancedscanningshowed

mildenhancementof

tumor.Enhancedscanning3.MRThereisasynechia(黏連)betweenthecancerandtheaorticarch.Thehighsignalfatlayerexist.CancerinvadethetracheaT2WI：Thefatlayerdisappearedandthewalloftracheabedamaged.T1Wenhancescanningshowsalumpinthetracheaandbeenhancedlikethecarcinoma.Differentialdiagnosis1.Achalasiaofcardiaandesophagus(食管賁門失弛緩征)2.Esophagealvarices(食管靜脈曲張)3.Leiomyomaoftheesophagus

(食道平滑肌瘤).1.Achalasiaofcardiaandesophagus

Intermittent

dysphagia(間歇性吞咽困難)Onawideneduppersegment

withfluidlevelLoweresophagusbecomethinlikeabeak(鳥嘴征)Withoutmucosalfoldbreak.2.EsophagealvaricesHaveahistoryoflivercirrhosis,portalhypertension.Beaded

fillingdefect(串珠樣充盈缺損)EnhancedCTscan

showed

vasculartortuosity

groupremarkableenhancementanddelayed

enhancement.Bariumemptyingdelay,butnoobstructionphenomenon.DietaryhabitsEsophageal

mucosalfoldsbebeak(粘膜迂曲、斷裂)Esophageal

wallcircularorirregularthickening(>5mm).Esophageal

mucosalfoldsbebeak(粘膜迂曲、斷裂)MushroomtypeHaveahistoryoflivercirrhosis,portalhypertension.Loweresophagusbecomethinlikeabeak(鳥嘴征)Leiomyomaoftheesophagus(食管平滑肌瘤)ClinicalfeatureAchalasiaofcardiaandesophagus(食管賁門失弛緩征)Differentialdiagnosis廣泛侵犯食管全層,形成腔外腫物，管腔狹窄，表面可見潰瘍Smoothcircularcavityfillingdefectwithoutmucosalfoldbreakandsurroundingtissueinvasionandmetastasis.Clinicalfeature（Carcinomaoccurmostfrequent）ThemiddlesegmentAnexpandoverthetumorMagneticResonanceImaging(MR)MedullarytypeThird:Esophagealhiatus(食管裂孔).AchalasiaofcardiaandesophagusConstrictivetype3.Leiomyomaoftheesophagus(食管平滑肌瘤)Smoothcircularcavityfillingdefectwithoutmucosalfoldbreakandsurroundingtissueinvasionandmetastasis.Exercise1.Canurememberthe3physiologicalstenosisofesophagus?(InthisquestionucanansweritinChinese)2.Pleaseshowusthefourtypesofthecarcinomaofesophagus.3.Tellmewhichesophagusdiseaseitisinthefollowingpictures.UlcerativecarcinomaTheendThankyou!Middleandadvancedstage3SectionsoftheesophagusPleaseshowusthefourtypesofthecarcinomaofesophagus.Singleor

multiplesmall

niches(龕影)FillingdefectBeaded

fillingdefect(串珠樣充盈缺損)Leiomyomaoftheesophagus(食管平滑肌瘤)Canurememberthe3physiologicalstenosisofesophagus?(InthisquestionucanansweritinChinese)Trachealbifurcation(氣管分叉)TheuppersegmentFillingdefectMiddleandadvancedstageSecond:locatedinthebackofleftprincipalbronchus.Esophageal

mucosalfoldsbebeak(粘膜迂曲、斷裂)Pathogeny(發病機制)Themiddlesegment（Carcinomaoccurmostfrequent）（Carcinomaoccurmostfrequent）ClinicalfeatureSecond:locatedinthebackofleftprincipalbronchus.Small

nodules(小結節)Tellmewhichesophagusdiseaseitisinthefollowingpictures.(周圍隆起,粘膜皺襞破壞)CancerinvadethetracheaUlcerativetype(潰瘍型)ClinicalfeatureFillingdefectDifferentialdiagnosisPathogeny(發病機制)Nitrosamines

contentofthese

foods

areveryhighClinicalfeature（Carcinomaoccurmostfrequent）ConstrictivetypeLeiomyomaoftheesophagus(食管平滑肌瘤)Therearemorethan300,000peopleworldwidediedfromesophagealcancereachyear,and150,000ofthemareChinese.Small

nodules(小結節)Pleaseshowusthefourtypesofthecarcinomaofesophagus.Loweresophagusbecomethinlikeabeak(鳥嘴征)Progressive

dysphagia

(進行性吞咽困難)Beaded

fillingdefect(串珠樣充盈缺損)T1Wenhancescanningshowsalumpinthetracheaandbeenhancedlikethecarcinoma.ClinicalfeatureCachexia(惡病質)Esophageal

mucosalfoldsbebeak(粘膜迂曲、斷裂)AnatomyoftheEsophagusTellmewhichesophagusdiseaseitisinthefollowingpictures.Paraesophageal

fatlayer

fuzzy,

disappear.Cavitylumpoccurred.Small

nodules(小結節)AnatomyoftheEsophagusnicheClinicalfeatureSymptomsareoftennotobvious,butwhenswallowingthecoarsefood,differentdegreesofuncomfortablefeelingsmayoccur.Pleaseshowusthefourtypesofthecarcinomaofesophagus.Cachexia(惡病質)Progressive

dysphagia

(進行性吞咽困難)Thehighsignalfatlayerexist.Pathogeny(發病機制)Medullarytype(髓質型)（Carcinomaoccurmostfrequent）EnhancedCTscan

showed

vasculartortuosity

groupremarkableenhancementanddelayed

enhancement.PhysiologicalstenosisofesophagusLeiomyomaoftheesophagus(食管平滑肌瘤)MedullarytypeBeaded

fillingdefect(串珠樣充盈缺損)ConstrictivetypeProgressive

dysphagia

(進行性吞咽困難)Tellmewhichesophagusdiseaseitisinthefollowingpictures.FillingdefectConstrictivetype(縮窄型)Cavitylumpoccurred.X-ray

barium

mealConstrictivetypeDifferentialdiagnosisNitrosamines

contentofthese

foods

areveryhighPleaseshowusthefourtypesofthecarcinomaofesophagus.Thereisasynechia(黏連