Section 10
Chapter 9,584

The histopathological examination of m3 and sm1 early esophageal carcinoma

Ohkura, Y.; El, E.

Stomach and Intestine 33(7): 975-984


ISSN/ISBN: 0536-2180
Accession: 009583702

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Eighteen cases of m3 early esophageal carcinoma and seven cases of sm1 carcinoma were examined histopathologically. This included macroscopical findings, mapping of the area of invasive depth of the carcinoma, degree of invasion to the muscularis mucosae, degree of dilatation of the muscularis mucosa, histological figures of carcinomatous epithelium and metastatic parameters. The macroscopic diagnosis of m3 and sm1 carcinomas and the indication for endoscopic mucosectomy of early esophageal carcinomas were discussed. The macroscopic diagnosis of invasive depth was more difficult in m3 carcinoma. The accuracy rate was 33.3%. In contrast with this, the accuracy rate for sm1 carcinoma was 70.1%. The reasons for misdiagnosis of m3 carcinoma were fastly, the rate of m3 invasive area was much smaller than that of m1 and m2. Secondly, the cases of carcinoma invading to the muscularis mucosae were relatively few. Thirdly, the dilatation of the muscularis mucosae and the focal thickness of the lesion, and the thickness of carcinomatous epithelium were not so different from one another and gradually shifted in each case. So to diagnosis m3 early carcinomas exactly, the characteristic macroscopical findings, such as small nodules and small thickened area, should be detected over a wide area of slightly irregular mucosa. In addition, much more careful examination was needed in cases of small carcinoma less than 2 cm in diameter and large ones more than 5 cm in their largest diameter. To diagnose sm1 carcinoma, spread of reddish and brownish irregular mucosa and thickening of mucosa over a wide area should be detected. The indication for endoscopic mucosectomy was not revealed in this study. From the date of metastatic tendency, intramucosal carcinomas invading to the muscularis mucosae are able to be resected endoscopically. However, after resection, detailed histopathological examination of all materials is necessary.

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