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Pathology of Small Cell Neuroendocrine Carcinoma of the Esophagus

Dr Sampurna Roy MD



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Age:  Middle aged or elderly male (mostly in sixth decade of life).

Clinical presentation: Dysphagia, weight loss. Poor prognosis. 

Associated with widespread metastasis. Often there is a history of heavy smoking.

Macroscopic features:  Present in mid and lower esophagus as a large exophytic, polypoid mass or stenotic lesion.

The lesion may vary in size from 5-15 cm in greatest diameter.

Microscopic feature:    

The tumour is characterized by small, round or oval lymphocyte-like cells with hyperchromatic nuclei, scant cytoplasm, and frequent mitoses.

In some cases in-situ lesions are present in the adjacent squamous epithelium.   

Foci of squamous carcinoma, adenocarcinoma, or both, may be present.  There may be mature-appearing balls of squamous cells.

General features include:

Small anaplastic cells ; Moulded nuclei ; Arranged in sheets (sometimes in cords and ribbons) ;  Rosettes formation containing mucin within their lumens in some case ; Foci of necrosis ; Vascular invasion ; Lymphnode metastases.

Visit: Small Cell Carcinoma of the Lung

Special stains:


The tumour stains positively with Chromogranin, PGP9.5, synaptophysin (endocrine markers).


The argyrophilic granules are demonstrated by the silver stain (Grimelius).

Differential diagnosis:

Metastatic oat cell carcinoma from primary lung tumour ; Poorly differentiated squamous cell carcinoma;Basaloid squamous cell carcinoma; Lymphoma.

Note:  Squamous cell carcinomas shows a general gradation of smaller to larger squamous cells with intercellular bridges.

Keratinization may be present.


Further reading:

Clinical impact of tumor-infiltrating inflammatory cells in primary small cell esophageal carcinoma.

MicroRNA profiles to predict postoperative prognosis in patients with small cell carcinoma of the esophagus.

Primary small cell carcinoma of the esophagus: clinicopathological study of 44 cases.

Primary small cell carcinoma of the esophagus: review of 64 cases from a single institution.

Primary undifferentiated small cell carcinoma of the esophagus.

Primary small cell carcinoma of the esophagus.

Small cell carcinoma of the esophagus. Clinicopathological and immunohistochemical findings in four cases.

Primary small-cell carcinoma of the esophagus. Report of 11 cases and review of the literature.

Clinicopathologic and immunohistochemical study on 22 cases of small cell carcinoma of the esophagus.

Small cell carcinoma of the oesophagus: a clinical and immuno histopathological review.

Small cell carcinoma of the esophagus.

Oat cell carcinoma of the esophagus with multiple differentiation.

Small cell carcinoma of the esophagus: evidence for a unified histogenesis.

Oat cell carcinomas of the oesophagus: a clinico-pathological study of 23 cases.



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Esophageal Pathology- Home Page    



Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


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