1、食管癌英文Content Anatomy of the Esophagus Summary Pathogeny(发病机制发病机制)Clinical feature Diagnose Differential diagnosis ExerciseAnatomy of the Esophagus The esophagus is a muscular tube,which is a digestive organ between the throat and stomach.Differential diagnosisT1W enhance scanning shows a lump in the
2、 trachea and be enhanced like the carcinoma.Have a history of liver cirrhosis,portal hypertension.Smooth circular cavity filling defect without mucosal fold break and surrounding tissue invasion and metastasis.Esophageal varices(食管静脉曲张)Tracheal bifurcation(气管分叉)Tell me which esophagus disease it is
3、in the following pictures.When the tumor invade the trachea,tracheoesophageal fistula(气管食管瘘)On a widened upper segment with fluid levelprotrude type(隆起型)Constrictive type(缩窄型)Limiting filling defect(局限性充盈缺损)The surrounding of the tumor become bulged,and the folds of mucous become damaged.The esophag
4、us is a muscular tube,which is a digestive organ between the throat and stomach.Physiological 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).3 Sections of the esophagus The upper segment The
5、middle segment （Carcinoma occur most frequent）The lower segmentTracheal bifurcation(气管分叉)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).Prevalence and mortality There are more than 300,000 people world
6、wide died from esophageal cancer each year,and 150,000 of them are Chinese.Pathogeny 1.Nitrosamine(亚硝胺亚硝胺)2.Fungus(真菌)3.Vitamin deficiency 4.Dietary habits NitrosamineNitrosamines content of these foods are very highClinical feature In early stage Symptoms are often not obvious,but when swallowing t
7、he coarse food,different degrees of uncomfortable feelings may occur.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)Classification of esophagealcancer 1.Ulcerative type(溃疡型)2.Mushroom
8、 type(蕈伞型)3.Constrictive type(缩窄型)4.Medullary type(髓质型)Diagnose 1.X-ray barium meal 2.Computed Tomography(CT)3.Magnetic Resonance Imaging(MR)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 stream slow
9、or temporary residence(钡剂流动缓慢或一过性滞留)PostoperationRecurSmall nodules(小结节)nicheProgressive dysphagia (进行性吞咽困难)The surrounding of the tumor become bulged,and the folds of mucous become damaged.Dietary habitsThe middle segmentDifferential diagnosisLower esophagus become thin like a beak(鸟嘴征)Vitamin defi
10、ciency（Carcinoma occur most frequent）Second:located in the back of left principal bronchus.T2WI：The fat layer disappeared and the wall of trachea be damaged.In early stageWhen the tumor invade the trachea,tracheoesophageal fistula(气管食管瘘)T1W enhance scanning shows a lump in the trachea and be enhance
11、d like the carcinoma.protrude type(隆起型)Early ulcerative typeTracheal bifurcation(气管分叉)Clinical featurePhysiological stenosis of esophagusIn the middle and advanced stageParaesophageal fat layer fuzzy,disappear.Dietary habitsLimiting filling defect(局限性充盈缺损)The carcinoma can encroach on the whole-laye
12、r of esophagus and make a stenosis,with ulceration on it.The carcinoma can encroach on the whole-layer of esophagus and make a stenosis,with ulceration on it.Enhanced scanningT2WI：The fat layer disappeared and the wall of trachea be damaged.Tell me which esophagus disease it is in the following pict
13、ures.Clinical featureHave a history of liver cirrhosis,portal hypertension.Early constrictive type(2).Middle and advanced stage a.Ulcerative type(溃疡型)niche The surrounding of the tumor become bulged,and the folds of mucous become damaged.(周围隆起,粘膜皱襞破坏)Filling defectAn expand over the tumorb.Mushroom
14、type c.Constrictive typeM,63Y,Progressive dysphagia 20d 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,with ulceration on it.2.CT 1.Esophageal wall circular or irregular thickening(5mm).2.Cavity lump occurred.3.Paraesophageal
15、 fat layer fuzzy,disappear.4.Peripheral organ got involved or lymph node metastasis.5.Enhanced scanning showed mild enhancement of tumor.Enhanced scanning3.MRThere is a synechia(黏连黏连)between the cancer and the aortic arch.The high signal fat layer exist.Cancer invade the tracheaT2WI：The fat layer di
16、sappeared and the wall of trachea be damaged.T1W enhance scanning shows a lump in the trachea and be enhanced like the carcinoma.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).1.Achalasia of cardia and esophagus In
17、termittent dysphagia(间歇性吞咽困难)On a widened upper segment with fluid level Lower esophagus become thin like a beak(鸟嘴征)Without mucosal fold break.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 r
18、emarkable enhancement and delayed enhancement.Barium emptying delay,but no obstruction phenomenon.There is a synechia(黏连)between the cancer and the aortic arch.The esophagus is a muscular tube,which is a digestive organ between the throat and stomach.Differential diagnosisProgressive dysphagia (进行性吞
19、咽困难)T1W enhance scanning shows a lump in the trachea and be enhanced like the carcinoma.When the tumor invade the trachea,tracheoesophageal fistula(气管食管瘘)Intermittent dysphagia(间歇性吞咽困难)Clinical feature广泛侵犯食管全层,形成腔外肿物，管腔狭窄，表面可见溃疡PostoperationCarcinoma of the esophagus is a common malignant tumor that
20、 occurs in a population cover 40 years old,and in predilection for male(好发于男性).In the middle and advanced stageLimiting filling defect(局限性充盈缺损)Cavity lump occurred.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.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.Ulcerative carcinomaThe end Thank you!谢谢观看！
