食管癌(英文版)
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• • • • 1. Nitrosamine(亚硝胺) 2. Fungus(真菌) 3. Vitamin deficiency 4. Dietary habits
Clinical feature
• In early stage Symptoms are often not obvious, but when swallowing the coarse food ,different degrees of uncomfortable feelings may occur.
Enhanced scanning
3. MR
The high signal fat layer exist.
There is a synechia(黏连) between the cancer and the aortic arch.
Cancer invade the trachea
T2WI：The fat layer disappeared and the wall of trachea be damaged.
Postoperation Recur
Small nodules(小结节)
protrude type(隆起型)
Early ulcerative type
Early constrictive type
(2). Middle and advanced stage
• a. Ulcerative type(溃疡型) • • niche •
Carcinoma of Esophagus
Speaker:LiuRan
Content
• • • • • • • Anatomy of the Esophagus Summary Pathogeny(发病机制) Clinical feature Diagnose Differential diagnosis Exercise
• c . Constrictive type
M,63Y, Progressive dysphagia 20d
• d. Medullary type
The carcinoma can encroach on the whole-layer of esophagus and make a stenosis,with ulceration on it.
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).
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.
Anatomy of the Esophagus
• The esophagus is a muscular tube, which is a digestive organ between the throat and stomach.
Physiological stenosis of esophagus
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 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 remarkable enhancement and delayed enhancement. • Barium emptying delay, but no obstruction phenomenon.
Classification of esophageal cancer
• • • • 1. Ulcerative type(溃疡型) 2. Mushroom 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)
广泛侵犯食管全层,形成腔外肿 物，管腔狭窄，表面可见溃疡
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.
• First: The junction of the pharynxBaidu Nhomakorabea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 surrounding of the tumor become bulged , and the folds of mucous become damaged. (周围隆
起,粘膜皱襞破坏)
b .Mushroom type
Filling defect An expand over the tumor
Ulcerative carcinoma
The end
• Thank you!
• The upper segment
Tracheal bifurcation (气管分叉)
• The middle segment
（Carcinoma occur most frequent）
• The lower segment
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).
1. X-ray barium meal
• (1). Early stage
Esophageal 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 or temporary residence(钡剂 流动缓慢或一过性滞留)
Clinical feature
In the middle and advanced stage
Progressive dysphagia (进行性吞咽困难) When the tumor invade the trachea , tracheoesophageal fistula(气管食管瘘) Cachexia(恶病质)
Prevalence and mortality
• There are more than 300,000 people worldwide died from esophageal cancer each year , and 150,000 of them are Chinese.
Pathogeny
Clinical feature
• In early stage Symptoms are often not obvious, but when swallowing the coarse food ,different degrees of uncomfortable feelings may occur.
Enhanced scanning
3. MR
The high signal fat layer exist.
There is a synechia(黏连) between the cancer and the aortic arch.
Cancer invade the trachea
T2WI：The fat layer disappeared and the wall of trachea be damaged.
Postoperation Recur
Small nodules(小结节)
protrude type(隆起型)
Early ulcerative type
Early constrictive type
(2). Middle and advanced stage
• a. Ulcerative type(溃疡型) • • niche •
Carcinoma of Esophagus
Speaker:LiuRan
Content
• • • • • • • Anatomy of the Esophagus Summary Pathogeny(发病机制) Clinical feature Diagnose Differential diagnosis Exercise
• c . Constrictive type
M,63Y, Progressive dysphagia 20d
• d. Medullary type
The carcinoma can encroach on the whole-layer of esophagus and make a stenosis,with ulceration on it.
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).
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.
Anatomy of the Esophagus
• The esophagus is a muscular tube, which is a digestive organ between the throat and stomach.
Physiological stenosis of esophagus
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 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 remarkable enhancement and delayed enhancement. • Barium emptying delay, but no obstruction phenomenon.
Classification of esophageal cancer
• • • • 1. Ulcerative type(溃疡型) 2. Mushroom 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)
广泛侵犯食管全层,形成腔外肿 物，管腔狭窄，表面可见溃疡
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.
• First: The junction of the pharynxBaidu Nhomakorabea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 surrounding of the tumor become bulged , and the folds of mucous become damaged. (周围隆
起,粘膜皱襞破坏)
b .Mushroom type
Filling defect An expand over the tumor
Ulcerative carcinoma
The end
• Thank you!
• The upper segment
Tracheal bifurcation (气管分叉)
• The middle segment
（Carcinoma occur most frequent）
• The lower segment
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).
1. X-ray barium meal
• (1). Early stage
Esophageal 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 or temporary residence(钡剂 流动缓慢或一过性滞留)
Clinical feature
In the middle and advanced stage
Progressive dysphagia (进行性吞咽困难) When the tumor invade the trachea , tracheoesophageal fistula(气管食管瘘) Cachexia(恶病质)
Prevalence and mortality
• There are more than 300,000 people worldwide died from esophageal cancer each year , and 150,000 of them are Chinese.
Pathogeny