Esophageal Adenocarcinoma Methods and Protocols

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Alfred K. Lam (ed.), Esophageal Adenocarcinoma: Methods and Protocols, Methods in Molecular Biology, vol. 1756,
https://doi.org/10.1007/978-1-4939-7734-5_6, © Springer Science+Business Media, LLC 2018

Chapter 6

Histopathological Assessment for Esophageal

Adenocarcinoma

Alfred K. Lam

Abstract

In the World Health Organization (WHO) classification, adenocarcinoma of esophagus comprises prein-
vasive type (dysplasia), adenocarcinoma, adenoid cystic carcinoma, adenosquamous carcinoma, and muco-
epidermoid carcinoma. For adenocarcinoma, it is important to determine the grading of the cancer and
histological variants such as signet ring adenocarcinoma. In the current day management of esophageal
adenocarcinoma by neoadjuvant therapy, the histology of the cancer and the lymph nodal status may
change after the therapy. Tumor regression grading systems could be used to assess the response to the
neoadjuvant therapy in esophageal adenocarcinoma.

Key words Esophagus, Adenocarcinoma, Mucoepidermoid carcinoma, Adenosquamous carcinoma,

Signet ring adenocarcinoma, Neoadjuvant therapy, Pathology

1 Introduction

For practical purpose, this group of carcinoma comprises adeno-

carcinoma of the esophagus as well as adenocarcinoma of the

esophagogastric junction (Fig. 1 ). Adenocarcinoma of esophago-

gastric junction is adenocarcinoma that crosses the esophagogas-

tric junction. The grouping is because the most common etiology

of GORD (gastresophageal reflux disease) for the majority of ade-

nocarcinoma arising from lower esophagus and esophagogastric

junction [ 1 ]. Esophageal adenocarcinoma often involves the

esophagogastric junction and the proximal portion of the stomach.

It is difficult to differentiate adenocarcinoma of esophageal/

esophagogastric origin from adenocarcinoma of proximal gastric

origin. The current definition of esophageal/esophagogastric ade-

nocarcinoma is adenocarcinoma involving the esophagus or within

2 cm from the esophagogastric junction [ 2 ]. This definition is the

most practical and reasonable approach. However, it is worth not-

ing that the location of esophagogastric junction is arbitrary and