title: Carcinosarcoma of the esophagus characterized by myoepithelial and ductal differentiations.
abstract: We report a case of carcinosarcoma of the esophagus characterized by ductal and myoepithelial differentiation. A 61-year-old man was operated on for a polypoid tumor of the distal esophagus. Histologically, this tumor was composed of ductal structures and sarcomatous spindle cells surrounding the ducts at the central area of the tumor. The tumor was also composed of squamous cell and basaloid carcinoma in the periphery. Immunohistochemically, a few spindle cells surrounding the ductal structures showed immunopositivity for alpha-smooth muscle actin and S-100 protein. Electron microscopy revealed that the spindle cells had tonofilament and pinocytic vesicles in the cytoplasm, and basal lamina adjacent to the cytoplasmic membrane. Both of the results strongly supported the suggestion that the spindle cells may be myoepithelial cells. Basaloid carcinoma showed a gradual transition to chondrosarcomatous cells producing the matrix, which had both immunopositivities for S-100 protein and cytokeratin. Therefore, chondrosarcomatous cells may be derived from carcinoma cells. The histogenesis of this tumor may be associated with a totipotent stem cell of esophageal mucosa, which has the potential to differentiate into squamous cells, ductal cells or myoepithelial cells.
authors.affiliation: Department of Pathology, Juntendo University, School of Medicine, Tokyo, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ohtaka
authors.forename: Toshio
authors.initials: T
authors.lastname: Kumasaka
authors.forename: Bunsei
authors.initials: B
authors.lastname: Nobukawa
authors.forename: Shu
authors.initials: S
authors.lastname: Hirai
authors.forename: Koichi
authors.initials: K
authors.lastname: Suda
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Ohno
authors.forename: Ryozo
authors.initials: R
authors.lastname: Iwazaki
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ikegami
authors.forename: Masaki
authors.initials: M
authors.lastname: Fukasawa
mesh_terms: D000199:Actins / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D002296:Carcinosarcoma / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D002471:Cell Transformation, Neoplastic; D004938:Esophageal Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009208:Myoepithelioma / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D015388:Organelles / Q000648:ultrastructure; D009418:S100 Proteins / Q000032:analysis
chemical_list: D000199:Actins; D014408:Biomarkers, Tumor; D009418:S100 Proteins