An Esophageal Collision Tumor
ABSTRACT An esophageal collision tumor is a rare situation that shows different neoplasms growing independently and simultaneously in close proximity until they become juxtaposed; however it should be rigorously distinguished from mixed or composite tumors in which one neoplastic clone diverges into two cell lineages that actually intermingle. The aim of this report is to clarify the clinicopathological feature of the esophageal collision tumor.
We investigated an esophageal collision tumor which was surgically resected. The esophageal lesion showed histologic heterogeneity. It harbored a component of squamous cell carcinoma in situ and a small blue cell tumor. The former was located in the lamina propria and the latter, in the submucosa. The small cellular component immunohistochemically exhibited the neuroendocrine phenotypes. The Ki-67 index of this element exceeded 80%. The interface between these two elements was abrupt. These pathological findings unmistakably met these rigorous criteria for a collision tumor including the neuroendocrine carcinoma and squamous cell carcinoma.
Although the exact oncogenic mechanism or the interaction of two independent neoplasms still remains unclear, further investigation such as electron microscopic features and genetic analysis of microsatellite instability may all aid in elucidating the pathomechanism of colliding tumors.
Full-textDOI: · Available from: Kensuke Adachi, Mar 31, 2014
- SourceAvailable from: Ulysses RibeiroClinics (São Paulo, Brazil) 01/2010; 65(1):114-7. DOI:10.1590/S1807-59322010000100018 · 1.42 Impact Factor
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ABSTRACT: Ten cases of small cell carcinoma of the esophagus were studied clinicopathologically and immunohistochemically. Seven of the ten were also examined by electron microscopy. Histologically, six were oat cell type, four the intermediate cell type, and multiple histologic sections revealed squamous and glandular differentiations in small or minute areas of seven and two tumors, respectively. In four of the six polypoid tumors, the epithelium covering the tumor showed a malignant conversion accompanied by a proliferation of small anaplastic cells. Another one showed a cribriform pattern in a small area of the tumor. Argyrophilic tumor cells were seen in six cases and tumor cells immunohistochemically positive for ACTH and calcitonin were seen in six, and three cases, respectively. Neurosecretory granules were evident in three of the seven cases examined by electron microscopy. These findings suggest that a small cell carcinoma of the esophagus differentiates toward a squamous, glandular, or neurosecretory lesion, thereby supporting the idea of a totipotential stem cell origin of this tumor. The prognosis of patients with this tumor was poor, in accord with the evidence of aggressive lymphatic and blood vessel permeation.Cancer 02/1989; 63(3):564-73. DOI:10.1002/1097-0142(19890201)63:3<564::AID-CNCR2820630328>3.0.CO;2-P · 4.90 Impact Factor