1、Carcinoma of Esophagus Speaker:LiuRan1PPT课件Content Anatomy of the Esophagus Summary Pathogeny(发病机制发病机制) Clinical feature Diagnose Differential diagnosis Exercise2PPT课件Anatomy of the Esophagus The esophagus is a muscular tube, which is a digestive organ between the throat and stomach.3PPT课件Physiologi
2、cal stenosis of esophagus First: The junction of the pharynx(咽) and esophagus. Second: located in the back of left principal bronchus. Third: Esophageal hiatus(食管裂孔). 4PPT课件3 Sections of the esophagus The upper segment The middle segment （Carcinoma occur most frequent） The lower segmentTracheal bifu
3、rcation (气管分叉)5PPT课件Summary Carcinoma of the esophagus is a common malignant tumor that occurs in a population cover 40 years old ,and in predilection for male(好发于男性).6PPT课件Prevalence and mortality There are more than 300,000 people worldwide died from esophageal cancer each year , and 150,000 of th
4、em are Chinese.7PPT课件Pathogeny 1. Nitrosamine(亚硝胺亚硝胺) 2. Fungus(真菌) 3. Vitamin deficiency 4. Dietary habits8PPT课件 NitrosamineNitrosamines content of these foods are very high9PPT课件Clinical feature In early stage Symptoms are often not obvious, but when swallowing the coarse food ,different degrees o
5、f uncomfortable feelings may occur.10PPT课件Clinical featureIn the middle and advanced stageu Progressive dysphagia (进行性吞咽困难)u When the tumor invade the trachea , tracheoesophageal fistula(气管食管瘘)u Cachexia(恶病质)11PPT课件Classification of esophagealcancer 1. Ulcerative type(溃疡型) 2. Mushroom type(蕈伞型) 3. C
6、onstrictive type(缩窄型) 4. Medullary type(髓质型)12PPT课件Diagnose 1. X-ray barium meal 2. Computed Tomography(CT) 3. Magnetic Resonance Imaging(MR)13PPT课件1. X-raybariummeal (1). Early stageEsophageal mucosal folds be beak(粘膜迂曲、断裂)Single or multiple small niches(龛影)Limiting filling defect(局限性充盈缺损)Barium st
7、ream slow or temporary residence(钡剂流动缓慢或一过性滞留)14PPT课件PostoperationRecur15PPT课件Small nodules(小结节)16PPT课件protrude type(隆起型)17PPT课件Early ulcerative type18PPT课件 Early constrictive type19PPT课件(2). Middle and advanced stage a. Ulcerative type(溃疡型) niche The surrounding of the tumor become bulged , and the
8、 folds of mucous become damaged. (周围隆起,粘膜皱襞破坏)20PPT课件 Filling defectAn expand over the tumorb .Mushroom type21PPT课件 c . Constrictive typeM,63Y, Progressive dysphagia 20d 22PPT课件 d. Medullary type广泛侵犯食管全层,形成腔外肿物，管腔狭窄，表面可见溃疡The carcinoma can encroach on the whole-layer of esophagus and make a stenosis
9、,with ulceration on it.23PPT课件2. CT 1. Esophageal wall circular or irregular thickening(5mm). 2. Cavity lump occurred. 3. Paraesophageal fat layer fuzzy, disappear. 4. Peripheral organ got involved or lymph node metastasis. 5. Enhanced scanning showed mild enhancement of tumor.24PPT课件25PPT课件Enhanced
10、 scanning26PPT课件3. MRThere is a synechia(黏连黏连) between the cancer and the aortic arch.The high signal fat layer exist.27PPT课件Cancer invade the tracheaT2WI：The fat layer disappeared and the wall of trachea be damaged.T1W enhance scanning shows a lump in the trachea and be enhanced like the carcinoma.
11、28PPT课件Differential diagnosis 1. Achalasia of cardia and esophagus(食管贲门失弛缓征) 2. Esophageal varices(食管静脉曲张) 3. Leiomyoma of the esophagus (食道平滑肌瘤).29PPT课件1. Achalasia of cardia and esophagus Intermittent dysphagia(间歇性吞咽困难) On a widened upper segment with fluid level Lower esophagus become thin like a
12、 beak(鸟嘴征) Without mucosal fold break.30PPT课件31PPT课件2. Esophageal varices Have a history of liver cirrhosis, portal hypertension. Beaded filling defect(串珠样充盈缺损) Enhanced CT scan showed vascular tortuosity group remarkable enhancement and delayed enhancement. Barium emptying delay, but no obstruction
13、 phenomenon.32PPT课件33PPT课件3. Leiomyoma of the esophagus(食管平滑肌瘤) Smooth circular cavity filling defect without mucosal fold break and surrounding tissue invasion and metastasis.34PPT课件35PPT课件Exercise 1. Can u remember the 3 physiological stenosis of esophagus? (In this question u can answer it in Chinese) 2. Please show us the four types of the carcinoma of esophagus. 3. Tell me which esophagus disease it is in the following pictures.36PPT课件Ulcerative carcinoma37PPT课件The end Thank you!38PPT课件
