第8章 消化系统疾病_3消化道肿瘤（课件）-高一《病理学·第4版》同步教学（科学出版社）

第八章 消化系统疾病 Alimentary system 病理学 消化系统疾病 disease of digestive system 消 化 道 肿 瘤 病理学 消化系统疾病 disease of digestive system 食管癌 Carcinoma of esophagus 发生与地理差异有关 鳞癌和腺癌 腺癌多源于化生 病理学 消化系统疾病 disease of digestive system Inf. Thyroid Arts. R. Bronch. Art. Thoracic. Aor. Left Gastric Art. Variations: Inf, Phrenic Celiac Splenic Short Gast. 中段 50% ，下段 30% ， 上段 20% 早期食道癌 癌组织局限于粘膜层或粘膜下层，未侵犯肌层， 无淋巴结转移 中晚期食道癌 病变肉眼可见 患者表现声嘶，进行性吞咽困难 病理学 消化系统疾病 disease of digestive system 病理学 消化系统疾病 disease of digestive system 病理学 消化系统疾病 disease of digestive system Gross: This is an example of an ulcerated squamous cell carcinoma of the esophagus. It differs from a benign peptic ulcer of the esophagus in that it is a much larger lesion and rather than being sharply punched-out, it has irregular borders. Note the perforation in the center. 鳞癌 squamous cell carcinoma： 溃疡型 ulcerated mid-esophageal 腔狭窄 lumenal stenosis. 病理学 消化系统疾病 disease of digestive system Normal esophageal wall 病理学 消化系统疾病 disease of digestive system This is normal esophageal squamous mucosa at the left, with underlying submucosa containing mucus glands and a duct surrounded by lymphoid tissue. The muscularis is at the right. 病理学 消化系统疾病 disease of digestive system At the upper left is a remnant of squamous esophageal mucosa that has been undermined by an infiltrating squamous cell carcinoma of the mid-esophagus. Solid nests of neoplastic cells are infiltrating down through the submucosa at the right. Esophageal cancers often spread to surrounding structures, making surgical removal difficult. 病理学 消化系统疾病 disease of digestive system Squamous cell carcinoma 病理学 消化系统疾病 disease of digestive system At high power, these infiltrating nests of neoplastic cells have abundant pink cytoplasm and distinct cell borders typical for squamous cell carcinoma. Esophageal carcinomas are not usually detected early and, therefore, have a very poor prognosis. Squamous cell carcinoma 病理学 消化系统疾病 disease of digestive system Dysplasi