Clinicopathological Study of Spindle Cell Squamous Carcinoma of the Esophagus

Objective To investigate the clinicopathological characters of spindle cell sqamous carcinoma of the esophagus,in order to understand the histogenesis of this tumor.Methods The clinical data,pathological changes of 5 cases with spindle cell sqamous carcinoma were retrospectively analyzed.Results There were 4 males and 1 female.The mean age was 57.2 years old.The tumors were located in the middle or low part of esophagus,and the gross pattern of the tumors appeared typically polypoid,medullary,fangating or ulcerative.Microscopically the tumors were composed of squamous cell carcinoma and sarcoma-like elements,while transitional features were not observed in 3 cases.Immunohistochemical examination disclosed positive expression of AE1/AE3 protein and vimentin protein in Sarcoma-like spindle cells.Specially,sarcomatous cells of the polypoid tumor in the condrosarcoma-like area only expressed vimentin protein and S-100 protein.In the fibrosarcoma zone,the tumor cell only expressed vimentin.Conclusion Spindle cell squamous carcinoma is a special type of carcinoma,which includes sarcomatoid carcinoma and carcinosarcoma.Sarcoma-like component of the spindle cell squamous carcinoma of the esophagus may be the result of a bi-directional differentiation of the malignant epithelial cells.The pathogenesis of carcinosarcoma needs further study.