benign tumor of esophagus
Introduction
Introduction to benign esophageal tumors Benign esophageal tumors are rare, accounting for only 1% of esophageal tumors. The age of onset is smaller than that of esophageal cancer, the symptoms progress slowly, and the disease period is long. In the benign esophageal tumors, the most common type is leiomyoma, which accounts for about 90%. In addition, there are polyps, lipomas, fibroids, papillomas, etc., which originate from the mucosa and submucosa. Esophageal leiomyoma is more common in middle-aged men. Most of the leiomyomas are located in the lower and middle segments of the esophagus, and most of them are single. Leiomyoma originates from the muscular layer of the esophageal wall and grows slowly into the esophageal lumen. The mucosa remains intact and thus does not cause hematemesis. The tumor is round, elliptical or horseshoe-shaped, with a complete envelope, tough, cut-off surface gray-white, with a spiral-shaped structural mass, 2 to 5 cm in diameter, but with a time of up to 10 cm, surrounding the long esophagus. basic knowledge The proportion of sickness: 0.00352% Susceptible people: no special people Mode of infection: non-infectious Complications: jaundice, ascites, coma
Cause
Esophageal benign tumor cause
Esophageal leiomyoma (35%):
It is a benign tumor that occurs in the muscular layer of the esophagus. Common in 20-60 years old, the lesion is common in the middle and lower esophagus, and the upper segment is less. Most of the tumors are single-shot, generally 2-5 cm, and a few can reach more than 10 cm. The tumor has a spherical, egg-shaped or lobulated irregular shape with a tough texture, a yellow-white cut surface, a clear boundary, and less blood supply. Microscopically, the tumor cells were long fusiform, rich in cytoplasm, and the nucleus was fusiform or rod-shaped, with no abnormality, and the smooth muscle fibers were bundled. Occasionally there are malignant people. Clinically, when the tumor is small, the patient may be asymptomatic or mildly symptomatic, manifesting as swallowing obstruction or dull sternal pain, but the severity of the symptoms is not parallel with the size of the tumor. High, large leiomyomas can sometimes compress the trachea. Cause breathing difficulties. X-ray examination of the esophagus showed an elliptical or half-moon filling defect, the mucosa was smooth, the turbulence passed smoothly, the esophageal peristalsis was normal, and the upper and lower edges of the tumor were acutely angled with the long axis of the normal esophagus; the larger leiomyomas protruded to the mediastinum.
Esophageal polyps (20%):
The clinical symptoms are related to the size of the polyps and whether the polyps are pedicled or not. When the polyp is huge or has inflammation, it may cause difficulty in swallowing and different degrees of pain in the upper abdomen or sternum. It may also bleed due to erosion of the mucosal surface. Because of the large polyps, the trachea may be forced to cause difficulty in breathing; the polyp can be spit out and spit out. The polyps sometimes block the throat and can cause suffocation. The diagnosis of this disease depends on X-ray examination and esophagoscopy of esophageal barium meal.
Esophageal cyst (20%):
Can be divided into two categories of congenital and acquired. The latter is a retention cyst caused by the atresia of the esophageal wall gland. The former is more common, it can be single or multiple, the capsule contains a viscous liquid, and sometimes it is bloody. Symptoms vary with the size of the cyst, the degree of compression around it, and the presence or absence of secondary infections, such as small cysts, and no infection, can be asymptomatic; cysts are large, oppressing surrounding organs or communicating with the esophagus or bronchus, Symptoms such as shortness of breath, cough, chest pain, and difficulty swallowing occur. X-ray examination and esophagoscopy of esophageal barium meal can be confirmed.
Esophageal hemangioma (15%):
It is common in the middle part of the esophagus. The local mucosa is ridged or lobulated and is bright red or purple. Common symptoms are hematemesis and black feces, and difficulty in swallowing.
Esophageal papilloma (10%):
It is a kind of benign tumor without pedicle. It protrudes from the lamina propria of the mucosa into the cavity. The center of the nipple is the central column composed of fibrovascular vessels, and the surface covers the proliferating squamous epithelium. It may be in the form of warts, nodules, cauliflower and diffuse infiltration. Small tumors can be asymptomatic, and when the tumor is large, it is difficult to swallow, pain and compression of surrounding organs. The diagnosis of this tumor must rely on esophagoscopy and deep biopsy for pathological examination.
Prevention
Esophageal benign tumor prevention
1. Improve factors that are closely related to our lives, such as quitting smoking, eating properly, exercising regularly, and losing weight. Anyone who follows these simple and reasonable lifestyles can reduce their chances of developing cancer.
2. The most important thing to improve the function of the immune system is: diet, exercise and control troubles, healthy lifestyle choices can help us stay away from cancer. Maintaining a good emotional state and proper physical exercise can keep your body's immune system at its best, and it is also good for preventing tumors and preventing other diseases.
Complication
Esophageal benign tumor complications Complications jaundice ascites coma
Common complications of esophageal tumors include hematemesis, blood in the stool, shortness of breath, irritating dry cough, accelerated heart rate, jaundice, ascites, liver failure, esophageal perforation, difficulty breathing, and coma.
Symptom
Esophageal benign tumor symptoms Common symptoms Chest when swallowing dry food...
Esophageal leiomyomas can not show clinical symptoms for a long time, but are occasionally found in X-ray examination of digestive tract barium meal. After leiomyomas grow up, it is more than 5cm, which can show post-sternal fullness, painful pressure and mild swallowing obstruction. . X-ray examination of esophageal barium meal can show a round or oval filling defect with smooth and tidy edges. The upper and lower edges are at an acute angle with the normal esophageal wall. The esophageal mucosal folds in the tumor area are flattened by the tumor but disappear without damage. It may be seen that the leiomyomas move up and down with the esophagus.
Common clinical esophageal benign tumors are divided into intraluminal, submucosal and interwall types according to the site of occurrence. Endoluminal types include benign polyps and papilloma; submucosal types include hemangioma and granulosa cell myoblastoma; the most common type of wall is esophageal leiomyomas. Benign esophageal tumors can block the esophageal lumen to varying degrees when the mass is large, and there are symptoms such as difficulty in swallowing, vomiting, weight loss, sternal pressure or pain.
The symptoms and signs of benign esophageal tumors mainly depend on the anatomy and volume of the tumor. Larger tumors can block the esophageal lumen to varying degrees, causing symptoms such as difficulty in swallowing, vomiting, and weight loss. Many patients have aspiration pneumonia, post-sternal pressure or pain. Hemorrhage can occur in patients with hemangioma.
Patients with small esophageal leiomyoma with small tumors can be followed up regularly, without having to rush to perform surgery. Esophageal leiomyoma removal should be performed if the tumor is clinically symptomatic or asymptomatic, but the patient is worried about the tumor after the tumor is found.
Examine
Examination of benign esophageal tumors
Inspection method
Esophagoscopy: It can be seen that the submucosal mass protrudes into the esophageal cavity but the mucosa is normal. When esophagoscopy is performed on patients with leiomyomas, biopsy is contraindicated to avoid damage to the esophageal mucosa and cause difficulty in tumor removal.
Precautions
When esophagoscopy is performed on patients with leiomyomas, biopsy is contraindicated to avoid damage to the esophageal mucosa and cause difficulties in subsequent tumor removal.
Diagnosis
Diagnosis and differentiation of benign esophageal tumors
diagnosis
Esophageal leiomyomas can not show clinical symptoms for a long time, but are occasionally found in X-ray examination of digestive tract barium meal. After leiomyomas grow up, it is more than 5cm, which can show post-sternal fullness, painful pressure and mild swallowing obstruction. . X-ray examination of esophageal barium meal can show a round or oval filling defect with smooth and tidy edges. The upper and lower edges are at an acute angle with the normal esophageal wall. The esophageal mucosal folds in the tumor area are flattened by the tumor but disappear without damage. It may be seen that the leiomyomas move up and down with the esophagus.
Differential diagnosis
Both esophageal cancer and benign esophageal tumors require X-ray and endoscopy to make a diagnosis. X-ray barium meal examination of esophageal cancer: early x-ray signs of esophageal cancer have localized mucosal fold thickening and rupture, or esophageal margin burr-like, small Filling defects, small ulcers and shadows. Localized esophageal wall stiffness or retention of the expectorant is mostly filling defect, stenosis of the lumen is disappeared, mucosal disorder, or obstruction; esophagoscopy is more commonly used in the diagnosis and differential diagnosis of early esophageal cancer and tumor. In addition, CT and MRI examinations have differential diagnostic value. The surgical treatment of benign esophageal tumors is good, and the prognosis is good. It is rare to have malignant changes.
