Esophageal squamous cell carcinoma with marked eosinophil infiltration

Abstract

We report a case of esophageal squamous cell carcinoma (SCC) with marked eosinophil infiltration which was identified postoperatively in the esophageal wall in areas not surrounding the SCC. The eosinophil infiltration was seen in the submucosa, muscle and adventitia, but not in the mucosa. Eosinophilic esophagitis (EoE) is a pathological condition defined as eosinophil infiltration within the esophageal mucosa. Eosinophil infiltration at the invasion front of esophageal SCC is termed tumor-associated tissue eosinophilia (TATE). However, the eosinophil infiltration in this case may be pathologically different from both EoE and TATE. To our knowledge, this is the first report of esophageal SCC with eosinophil infiltration.

Keywords: Eosinophil infiltration; Esophageal squamous cell carcinoma; Esophagectomy.

Fig. 1

Endoscopic examination. a An elevated, granular lesion is shown 32–34 cm from the incisor teeth. b Iodine staining left the tumor unstained, but the tumor margins became clearer.

Fig. 2

Surgical specimens. The SCC (2.5 × 2.5 cm) was not stained with iodine. The rest of the esophageal wall was normal in appearance.

Fig. 3

Microscopic examination. a The SCC had partially invaded the middle layer (H&E, ×20). Eosinophil infiltration was not seen around the SCC. b–e There was eosinophil infiltration of the full length of the esophageal wall except around the SCC. Eosinophil infiltration was not seen in the mucosa (b, H&E, ×20), but was marked in the muscle, submucosa and adventitia (c, d, e, H&E, ×100). f There was eosinophil infiltration of the muscle layer with more than 100 eosinophils per high-power field (H&E, ×400).