Original Articles
Copyright ©The Author(s) 1998. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 15, 1998; 4(5): 397-403
Published online Oct 15, 1998. doi: 10.3748/wjg.v4.i5.397
Basaloid squamous carcinoma of esophagus: a clinicopathological, immunohistochemical and electron microscopic study of sixteen cases
Xin-Hua Zhang, Gui-Qin Sun, Xiao-Jun Zhou, Hui-Fang Guo, Tai-He Zhang
Xin-Hua Zhang, Gui-Qin Sun, Xiao-Jun Zhou, Hui-Fang Guo, Tai-He Zhang, Department of Pathology, Chinese PLA General Hospital of Nanjing Command Area, Nanjing 210002, Jiangsu Province, China
Xin-Hua Zhang, male, born on 1960-05-11 in Tiaotai County, Zhejiang Province, Han nationality, graduated from Shanghai Second Medical University as a postgraduate in 1988, vice-chief doctor, majoring diagnostic pathology, having 15 papers published.
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Xin-Hua Zhang, Department of Pathology, Chinese PLA General Hospital of Nanjing Command Area, 305 East Zhongshan Road, Nanjing 210002, Jiangsu Province, China. zhouxj@public1.ptt.js.cn
Telephone: +86-25-3387871-58192 Fax.+86-25-4402352
Received: April 20, 1998
Revised: May 22, 1998
Accepted: June 17, 1998
Published online: October 15, 1998
Abstract

AIM: To further clarify the clinicopathological, immunohistochemical and electron microscopic features, and prognostic aspect of basaloid squamous carcinoma (BSC), a rare esophageal carcinoma.

METHODS: We reviewed 763 documented cases of esophageal malignancies (1977-1996) from our hospital, and discovered 16 (2.1%) cases of BSC. The clinicopathological features of these cases were evaluated. Immunohistochemistry (S-P method), histochemical stains, and electron microscopy were used to further characterize the neoplasm.

RESULTS: The tumors were classified into stages I (n = 1), IIA (n = 6), IIB (n = 2), III (n = 5), and IV (n = 2) according to the criteria of the UICC TNM classification system of malignant tumors (1987). Most neoplasms were located in the mid third of the esophagus. Grossly, they had a similar appearance of conventional esophageal carcinoma, but showed a typical cytoarchitectural pattern of BSC histologically. The most important histologic feature of this tumor is carcinoma with a basaloid pattern, intimately associated with squamous cell carcinoma, dysplasia, or focal squamous differentiation. The basaloid cells were round to oval in shape with scant cytoplasm, arranged mainly in the form of solid, smooth-contoured lobules with peripheral palisading. A panel of immunostains were used for the basaloid component of the tumor with the following results: CK (Pan) 14/16 (+); EMA 16/16 (+); Vimentin 4/16 (+); S-100 protein 7/16 (+). CEA and smooth muscle actin were negative. Electron microscopy (EM) revealed that the basaloid cells were poorly differentiated, with a few desmosomes and fibrils, and numerous free and polyribosome. Of the 11 patients with adequate follow-up 8 died within 2 years, with an average survival time of 16.2 months. No stage II, III or IV cases survived beyond 5 years. The one-year survival rate was 60% and two-year 20%.

CONCLUSION: The BSC of esophagus is a distinct clinicopathological entity with poor prognosis. The cellular differentiation and biologic behavior of esophageal BSC were assumed to occupy a station intermediate between that of conventional squamous cell carcinoma and small undifferentiated cell carcinoma.

Keywords: esophageal neoplasms/pathology; esophageal neoplasms/ultrastructure; carcinoma, squamous cell/pathology; carcinoma, squamous cell/ultrastructure