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 |
