Well Differentiated Squamous Cell Carcinoma of the Esophagus Showing Dedifferentiation to Undifferentiated Carcinoma at Metastatic Lymph Nodes

Keiji Hayata, Makoto Iwahashi, Masaki Nakamura, Mikihito Nakamori, Yoshihiro Nakatani, Koichiro Ishida, Teiji Naka, Takeshi Iida, Ichiro Mori* and Hiroki Yamaue

Second Department of Surgery and Division of Pathology, Department of Laboratory Medicine*, Wakayama Medical University, School of Medicine

A 64-year-old man admitted for dysphagia was found in gastrointestinal endoscopy to have circular stenosis due to esophageal carcinoma,with biopsy squamous cell carcinoma with keratin pearl formation, necessitating subtotal esophagectomy and 3-field lymph node dissection. Pathological examination showed well-differentiated squamous cell carcinoma (SCC) at the primary lesion with lymph node metastasis (#3, #7, #106recR, L, #101R, L, #104R, L). Poorly differentiated SCC and undifferentiated non-small-cell carcinoma were mixed in metastatic lymph nodes of the neck. Tumor cells of this type were confirmed to be derived from epithelial cells because immunohistochemical staining findings were positive for AE1/3 and EMA but negative for chromogranin A, synaptophysin, NSE, and vimentin. Undifferentiated non-small-cell carcinoma may result from dedifferentiation of squamous cell carcinoma.

Key words
esophageal cancer, non-small-cell type, undifferentiated carcinoma

Reprint requests
Makoto Iwahashi Second Department of Surgery, Wakayama Medical University, School of Medicine
811-1 Kimiidera, Wakayama, 641-8510 JAPAN

Accepted
October 19, 2005

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