Surgical Pathology Criteria

Squamous Carcinoma of the Esophagus

Differential Diagnosis

Esophageal Basaloid Squamous Carcinoma Esophageal Poorly Differentiated Endocrine (Small Cell Undifferentiated) Carcinoma
Well defined solid sheets, lobules and nests Diffuse permeating pattern of infiltration
Stromal hyalinization common Lacks stromal hyalinization
Frequent intermingling squamous differentiation More than focal squamous differentiation infrequent
Lacks nuclear molding Prominent nuclear molding
Nuclear pleomorphism (at high magnification) Little nuclear pleomorphism
May have distinct but small nucleoli Nucleoli inconspicuous
HMWCK and p63 usually strongly positive HMWCK and p63 negative or focal and weak

 

Esophageal Basaloid Squamous Carcinoma Esophageal Adenoid Cystic Carcinoma
Frequent intermingling squamous differentiation Squamous differentiation infrequent
Frequent coagulative tumor cell necrosis Necrosis rare
Lacks 2 cell type pattern 2 cell type differentiation (pale ductal and dark basaloid)
Nuclear pleomorphism (at high magnification) Uniform small hyperchromatic nuclei
Frequent mitotic figures Mitotic figures infrequent
p63 diffuse positivity and smooth muscle actin usually negative p63 and smooth muscle actin clearly define a surrounding myoepithelial component
Perineural invasion infrequent Perineural invasion common

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