Clinicopathological and Immunohistochemical Evaluation of Undifferentiated Carcinoma of the Esophagus

Masashi Takemura, Masayuki Higashino, Harushi Osugi, Taigo Tokuhara, Nobuyasu Takada, Kozo Fujiwara, Hiroshi Kato, Toshio Ihara, Hiroaki Kinoshita

Second Department of Surgery, Osaka City University Medical School

Undifferentiated carcinoma of the esophagus is rare among esophageal malignancies and has a poor prognosis because of excessive lymphatic and hemogenous metastasis at the early stage. We present six cases of undifferentiated carcinoma of the esophagus, and compared them with 128 cases of squamous cell carcinoma of the esophagus clinicopathologically and immunohistochemically. The mean age of the patients (five male and one female) was 64 years. Five patients had intrathoracic esophagectomy with 3-field lymph node dissection and the other one patient had palliative esophagectomy because of tumor invasion into the left main bronchus. Histological examination revealed that the tumor in 4 patients were small cell type and in the other 2 patients were non small cell type. Lymph node metastasis was found histologically in all 5 patients who had lymphadenectomy. Twelve percent of the dissected lymph nodes had metastatic lesion in patients with undifferentiated carcinoma, which was higher than that in patients with squamous cell carcinoma (7%). Immunohistochemically, specimens of 5 patients stained for Neuron specific enolase. The specimen from one of the small cell type lesions stained for Epithelial membrane antigen as well. Carcinoembryonic antigen and keratin were not stained in these samples. In conclusion, the results suggest that the cells which composed undifferentiated carcinoma of the esophagus may have multipotential of differentiation.

Key words
undifferentiated carcinoma of the esophagus, immunohistochemical stain, treatment for undifferentiated carcinoma of the esophagus

Reprint requests
Masashi Takemura Second Department of Surgery, Osaka City University Medical School
1-5-7 Asahi-machi, Abeno-ku, Osaka, 545 JAPAN

Accepted
November 13, 1996

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