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Epidermization in the esophageal mucosa: unusual epithelial changes clearly detected by Lugol's staining
Y Nakanishi1, A Ochiai, T Shimoda
1Division of Pathology, National Cancer Center Research Institute and Hospital, Tokyo, Japan.
Insights
This study reports a rare case of superficial esophageal cancer with epidermization, a change mimicking skin. Lugol's iodine staining highlighted lesions invisible to the naked eye, aiding diagnosis.
Area of Science:
- Gastroenterology
- Oncology
- Pathology
Background:
- Superficial esophageal cancer presents unique diagnostic challenges.
- Unusual epithelial changes can complicate macroscopic evaluation.
Observation:
- A 58-year-old Japanese man presented with superficial esophageal cancer and epidermization.
- Lugol's iodine staining revealed irregular, unstained lesions not apparent macroscopically.
- Histological examination identified epidermization, acanthosis, and epithelial atrophy.
Findings:
- Immunohistochemical staining for keratins in epidermized and atrophic areas resembled epidermal patterns.
- Keratin staining in the acanthotic lesion was similar to oral epithelium.
Implications:
- This case highlights the utility of Lugol's iodine in detecting subtle esophageal lesions.
- Understanding these keratinization patterns may improve the diagnosis of esophageal malignancies.
Abstract:
A 58-year-old Japanese man with superficial esophageal cancer accompanied by unusual epithelial changes, including esophageal mucosal epidermization, is reported. Staining with Lugol's iodine clearly showed irregular unstained lesions, which could not be seen clearly macroscopically, in the resected specimen. Histologic examination of the irregular unstained areas showed definite granular and horny layers regarded as epidermization, acanthosis with slight nuclear enlargement, and epithelial atrophy. The immunohistochemical staining patterns of keratins in the epidermized and atrophic lesions were similar to those in the epidermis, and the keratin staining patterns of the acanthotic lesion were similar to those of the oral epithelium.