Esophagus
Carcinoma
Intramucosal carcinoma
Author: Elliot Weisenberg, M.D.
Last author update: 1 June 2013
Last staff update: 14 June 2022
Copyright: 2003-2023, PathologyOutlines.com, Inc.
PubMed Search: Intramucosal carcinoma[TI] esophagus
See also: Adenocarcinoma, Arising in ectopic gastric mucosa, Gastroesophageal junction
Table of Contents
Definition / general | Terminology | Clinical features | Diagnosis | Prognostic factors | Treatment | Microscopic (histologic) description | Microscopic (histologic) images | Differential diagnosisCite this page: Weisenberg E. Intramucosal carcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/esophagusadenocarcinomaintramucosal.html. Accessed June 2nd, 2023.
Definition / general
- Carcinoma that has penetrated through basement membrane of glands of lamina propria but not yet invaded through muscularis mucosae into submucosa; most biopsy specimens will not be deep enough to rule out submucosal invasion
- Epidermiology, sites, pathophysiology similar to adenocarcinoma
Terminology
- In AJCC staging, invasion of lamina propria or muscularis mucosae without involvement of submucosa is a T1a primary tumor
Clinical features
- True intramucosal carcinoma is asymptomatic although patients often have GERD symptoms
Diagnosis
- Endoscopic biopsy
Prognostic factors
- Usually node negative (J Am Coll Surg 2006;203:152)
- 10 year survival after esophagectomy for stage IA (T1aN0M0) is 75% worldwide, similar to stage 0 disease
Treatment
- Esophagectomy, mucosectomy, radiofrequency ablation
Microscopic (histologic) description
- Odze requires one of these findings (J Clin Path 2006;59:1029)
- Single cells or small clusters of tightly compact back to back glands in lamina propria
- Complex gland in gland or "cribriforming" pattern, with expansion of lamina propria and distortion of surrounding crypts
- Neoplastic cells or glands show back to back or highly irregular architectural glandular arrangement, which cannot be explained by the preexisting Barrett glands, as previously defined by Ormsby (Gut 2002;51:671)
Microscopic (histologic) images
AFIP images
High grade dysplasia, early intramucosal carcinoma
Images hosted on other servers:
Intramucosal carcinoma
Suggestive of intramucosal carcinoma
Differential diagnosis
- High grade dysplasia: no syncytial arrangements of cells or complex glandular budding; low interobserver agreement, even among expert GI pathologists (Am J Gastroenterol 2008;103:2333)
