Table of Contents
Definition / general | Treatment | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Differential diagnosisCite this page: Weisenberg E. Squamous dysplasia. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/esophagussquamousdysplasia.html. Accessed February 7th, 2023.
Definition / general
- Also called esophageal intraepithelial neoplasia (EIN), CIS when full thickness
- Frequently found adjacent to carcinoma especially in superficial tumors and in tumors when neoadjuvant therapy not performed (Cancer 1987;59:783)
- Same risk factors as esophageal squamous cell carcinoma
- High grade but not low grade dysplasia is risk factor for invasive disease (Cancer 1994;74:1686)
- May be distant from main lesion, suggesting a field effect
Treatment
- Excision, including endoscopic mucosal resection (Endoscopy 2007;39:24)
Gross description
- Normal, erythematous mucosa or plaques / nodules; highlighted by application of Lugol solution (Cancer 1998;83:220) or toluidine blue on mucosal surface
Microscopic (histologic) description
- Low grade (abnormal cells limited to basal half of epithelium) or high grade (abnormal cells in upper half of mucosa); nuclear enlargement, pleomorphism, hyperchromasia, mitotic figures; epithelial buds bulge into the stroma
- Traditional 3 grade system: grade 1 (regular buds, same size), grade 2 (regular buds, variable size), grade 3 (buds of varying length and width with irregular contours); now a two tiered system, low grade (formerly grade 1) and high grade (encompassing grade 2 and grade 3) is preferred (Am J Surg Pathol 1989;13:685)
- Dysplastic involvement of submucosal gland ducts may mimic invasion; may have pagetoid spread of dysplastic cells
- Reactive epithelial changes associated with severe inflammation may necessitate a diagnosis of indefinite for dysplasia; rebiopsy after treatment
- Basal squamous dysplasia: abnormal cells are confined to basal half or 2/3 of epithelium
Microscopic (histologic) images
AFIP images
Basal squamous dysplasia
Images hosted on other servers:
Differential diagnosis
- Microinvasive squamous cell carcinoma: usually larger keratinized cells with more atypia and pleomorphism than dysplasia