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食管癌英文ContentAnatomyoftheEsophagusSummaryPathogeny(發(fā)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(fā)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(jié)節(jié))ClinicalfeatureAnatomyoftheEsophagusPathogeny(發(fā)病機制)Classificationofesophageal
cancerPeripheral
organgotinvolved
or
lymphnodemetastasis.3SectionsoftheesophagusAchalasiaofcardiaandesophagusAnatomyoftheEsophagusPathogeny(發(fā)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(zhì))Nitrosamine(Carcinomaoccurmostfrequent)X-ray
barium
meal3SectionsoftheesophagusClassificationofesophageal
cancerClassificationofesophageal
cancerSmall
nodules(小結(jié)節(jié))Pathogeny(發(fā)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(zhì))Classificationofesophageal
cancer1.Ulcerativetype(潰瘍型)2.Mushroomtype(蕈傘型)3.Constrictivetype(縮窄型)4.Medullarytype(髓質(zhì)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(jié)節(jié))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(jié)節(jié))PostoperationThecarcinomacanencroachonthewhole-layerofesophagusandmakeastenosis,withulcerationonit.ThemiddlesegmentBeaded
fillingdefect(串珠樣充盈缺損)Pathogeny(發(fā)病機制)AnatomyoftheEsophagusEsophageal
wallcircularorirregularthickening(>5mm).Pathogeny(發(fā)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(fā)病機制)Themiddlesegment(Carcinomaoccurmostfrequent)(Carcinomaoccurmostfrequent)ClinicalfeatureSecond:locatedinthebackofleftprincipalbronchus.Small
nodules(小結(jié)節(jié))Tellmewhichesophagusdiseaseitisinthefollowingpictures.(周圍隆起,粘膜皺襞破壞)CancerinvadethetracheaUlcerativetype(潰瘍型)ClinicalfeatureFillingdefectDifferentialdiagnosisPathogeny(發(fā)病機制)Nitrosamines
contentofthese
foods
areveryhighClinicalfeature(Carcinomaoccurmostfrequent)ConstrictivetypeLeiomyomaoftheesophagus(食管平滑肌瘤)Therearemorethan300,000peopleworldwidediedfromesophagealcancereachyear,and150,000ofthemareChinese.Small
nodules(小結(jié)節(jié))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(zhì))Esophageal
mucosalfoldsbebeak(粘膜迂曲、斷裂)AnatomyoftheEsophagusTellmewhichesophagusdiseaseitisinthefollowingpictures.Paraesophageal
fatlayer
fuzzy,
disappear.Cavitylumpoccurred.Small
nodules(小結(jié)節(jié))AnatomyoftheEsophagusnicheClinicalfeatureSymptomsareoftennotobvious,butwhenswallowingthecoarsefood,differentdegreesofuncomfortablefeelingsmayoccur.Pleaseshowusthefourtypesofthecarcinomaofesophagus.Cachexia(惡病質(zhì))Progressive
dysphagia
(進行性吞咽困難)Thehighsignalfatlayerexist.Pathogeny(發(fā)病機制)Medullarytype(髓質(zhì)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
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