Neoplastic Mimics of the Esophagus

Arief A. Suriawinata and Hongfa Zhu

INTRODUCTION

Neoplastic mimics of the esophagus take the form of white plaques such as seen in glycogenic acanthosis, polyp in squamous papilloma, and ulceration in gastroesophageal reflux disease and Crohn’s disease (Table 3.1). Endoscopically and microscopically, these lesions can mimic neoplasms of the esophagus, that is, squamous cell carcinoma and adenocarcinoma. Squamous cell carcinoma tends to occur in the proximal to middle third of the esophagus, whereas adenocarcinoma occurs in the distal third of the esophagus in association with Barrett’s esophagus.

TABLE 3.1 Neoplastic Mimics of the Esophagus

GROSS CONFIGURATION	NEOPLASTIC MIMICS	NEOPLASM
Mucosal plaque	Glycogenic acanthosis	Squamous cell dyplasia, carcinoma
	Gastric heterotopia “inlet patch”	Adenocarcinoma
Polyps	Squamous papilloma	Squamous cell carcinoma
	Fibrovascular polyp	Squamous cell carcinoma
	Inflammatory fibroid polyp	Gastrointestinal stromal tumor, leiomyoma
Ulcerating lesion	Crohn’s disease	Squamous cell carcinoma, adenocarcinoma
	Gastroeosphageal reflux ulcer	Adenocarcinoma