Gullet tumors at children of all age periods meet seldom, identical frequency at boys and girls.
BENIGN TUMOURS OF THE GULLET
Benign tumors of a gullet, unlike malignant, grow slowly without breaking health and the general state. On morphology epithelial (cysts, papillomas, adenomatous polyps, etc.) and not epithelial (leiomyomas, fibromas, myomas, neuromas, hemangiomas, etc.), as growth — intra esophageal, intramural, extra esophageal distinguish tumors. 50 — 70% of benign tumors make leiomyomas. They come from actually muscular coat and represent the single node of whitish color, a dense consistence covered with a capsule and located more often on one of gullet walls (seldom tsirkulyarno covers its gleam). On the place, the 2nd for frequency, there are cysts representing the thin-walled educations containing light viscous liquid. They can be acquired (retentsionny cysts), formed at obstruction of channels of glands, or inborn (bronchogenic and enterogenous) which are a consequence of a malformation of a trachea or a digestive tube.
MAIN SYMPTOMS OF BENIGN TUMOURS OF THE GULLET
The symptoms caused by damage of a gullet.
Dysphagy. Pains behind a breast, under a shovel, in spin, in time or soon after food. Bleedings, anemia, dystrophy. Vomiting, vomiting, nausea, an eructation, heartburn, hypersalivation, appetite loss (at the accompanying peptic ulcer, hernia of an esophageal opening of a diaphragm).
The symptoms caused by a prelum of bodies of a mediastinum.
Cough, short wind. Heartbeat, arrhythmia, cyanosis. Inspection methods: survey of a stomatopharynx, X-ray analysis, endoscopy, cytology of washouts, histology of bioptat.
MALIGNANT TUMOURS OF THE GULLET
The most dangerous disease of this group is the gullet cancer. For designation of precancerous changes the term "dysplasia" meaning certain ratios between kernels and cytoplasm is used. The cancer of a gullet is preceded a chronic esophagitis, by leukoplakias, ulcers, papillomas and polyps.
Pathomorphologic classification of cancer of gullet.
Exophytic (nodal) makes 60% of cases. A tumor surface granular, with dot hemorrhages which can pass to a surrounding mucous membrane. Large nodes remind a cauliflower.
Endophytic (ulcer) makes 30% of cases. In an early stage has an appearance of a flat node in the thickness of a mucous membrane, but soon ulcerates and quickly extends tsirkulyarno.
The sclerosing (circular) form is observed at 10% of patients. The tumor grows slowly tsirkulyarno, infiltriruya mucous and muscular layers. Later the esophagitis and an ulceration develops. The mixed forms with the ekzofitnoendofitny growth of a tumor are possible.
Patterns of innidiation of cancer of cervical department: cellular space of a neck, supraclavicular area and mediastinum. At cancer of chest department metastasises in lymph nodes of a mediastinum and periesophagal cellulose. Metastasises in lymph nodes of an omentulum are typical for cancer of the middle and lower part of a gullet.
MAIN SYMPTOMS OF MALIGNANT TUMOURS OF THE GULLET
The general symptoms which meet at various chronic diseases including cancer.
The symptoms characteristic of a disease of bodies of a chest cavity (dull aches in a breast and a back, the asthma developing by the end of food, tachycardia after food, change of a timbre of a voice, etc.).
Symptoms of a direct injury of a gullet, main among which a dysphagy (80% of cases).
Fig. 1. The scheme of various forms of a tumor of a gullet with destruction existence (on the right — a X-ray pattern): 1 — a tumor with intra esophageal type of growth. 2 — a tumor with extra esophageal type of growth; 3 — an intraparietal tumor
Fig. 2. The scheme of various forms of a tumor of a gullet without destruction (on the right — a X-ray pattern): 1 — a tumor with intra esophageal type of growth; 2 — a tumor with extra esophageal type of growth; 3 — an intraparietal tumor