Preface to the Third Edition

This third edition of Pathology of the Esophagus is published justafter my retirement and will be the last edition compiled by me.The opening page of this edition carries photos taken at theInternational Symposium: Tokyo Esophageal Research Day 2015,to commemorate the retirement of Dr. Kaiyo Takubo, and also onthe excursion to Nara and Kyoto after the Symposium. The followingpage also carries the text of the speech made by Professor HenryAppelman who proposed the toast at the party to mark myretirement.

Esophageal diseases have become a focus of clinical interest,especially in view of the rapid increase in the number of cases ofgastroesophageal reflux disease (GERD), Barrett's esophagus,and Barrett's carcinoma. This book presents a comprehensivedescription of the esophagus based on many works published inEnglish as well as in Japanese. Topics range from the embryologyand structure of the esophagus, to benign diseases and variousesophageal infections, to esophageal malignancies, includingBarrett's carcinoma. In the third edition, many new diagrams andhistologic and endoscopic images, approximately 80 figures in all,have been added. Photos that had appeared in the second editionhave been comprehensively improved, and various letters andarrows have been inserted in the illustrations with the aid of myphototechnologist colleague, Mr. Yoshihiro Fujita, to aid understandingof the explanations.

Images obtained by the new techniques of endocytoscopy,allowing histopathologic diagnosis in situ, and magnifying endoscopyhave been included, and new references covering the last10 years have also been added and reviewed. This edition providesa valuable source of information for pathologists, researchers,surgeons,and practicing endoscopists.

For this edition, specialists from all over the world generously provided not only specimens obtained by resection and biopsy butalso endoscopic images. These contributors are gratefully acknowledgedby name in the book. Among them, I am particularly gratefulto Dr. Miwako Arima, Department of Gastroenterology, SaitamaCancer Center Hospital, for supplying many beautiful endoscopicimages; Dr. Yoichi Kumagai, Department of Surgery, Saitama Medical University, for supplying many clear endocyotoscopyimages; and Dr. Junko Aida, Research Team for GeriatricPathology, Tokyo Metropolitan Institute of Gerontology, for providingmany histologic images for this edition. I also wish to thankDrs Ken‐ichi Nakamura, Naotaka Izumiyama‐Shimomura, YokoMatsuda, and Tomio Arai, members of the Research Team forGeriatric Pathology, Tokyo Metropolitan Institute of Gerontology,and Department of Pathology, Tokyo Metropolitan GeriatricHospital, for their help in preparing the manuscript.

The publication of the book was supported in part by FukushōjiBuddhist Temple, Kita‐ku, Tokyo, where I serve as the head priest,and many temple members contributed generously to thepublicationcost. Many copies of the first and second editions weredonated to medical doctors and universities throughout the world,and a considerable number of copies of this edition will also bedonated to Asian and African countries.

I retain copyright of the third edition, with the intention oftransferring it at no cost to a young pathologist in the near future,in the expectation that he or she will take responsibility forpublishingthe fourth, fifth, and further editions, and subsequentlyalso hand over the copyright without payment to a third doctor.In this way, it is my sincere expectation that new editions willcontinueto be published for a long time to come.

Kaiyo Takubo
Tokyo, March 1, 2016

Preface to the Third Edition

Preface to the Second Edition

Preface to the First Edition

Acknowledgments

1.1.Embryology of the Esophagus

1.2.Developmental Anomalie

2.1.Anatomy of the Esophagus

2.2.Histology, Cytology, and Electron Microscopy of the Normal Esophagus

3.1.Esophageal Varices

3.2.Dieulafoy's Lesion of the Esophagus

4.1.Achalasia

4.2.Secondary Achalasia

4.3.Diffuse Esophageal Spasm, Nutcracker Esophagus, and Hypertensive Lower Esophageal Sphincter

4.4.Alcoholic Neuropathy and Deterioration of Esophageal Peristalsis

4.5.Allgrove's Syndrome

4.6.Aging and Changes in the Nerve Plexus and Smooth Muscle

5.1.Viral Esophagitis

5.2.Fungal Esophagitis

5.3.Bacterial Esophagitis

5.4.Syphilis

5.5.Other Infections

6.1.Progressive Systemic Sclerosis

6.2.Polymyositis, Dermatomyositis, Systemic Lupus Erythematosus, and Rheumatoid Arthritis

6.3.Sjögren's Syndrome

6.4.Idiopathic Eosinophilic Esophagitis

6.5.Lymphocytic Esophagitis

6.6.Skin Disorders

6.7.Graft‐Versus‐Host Disease

6.8.Behçet's Disease

6.9.Crohn's Disease

6.10.Sarcoidosis

6.11.Ulcerative Colitis

6.12.Amyloidosis

6.13.Parkinson's Disease

6.14.Ceroidosis (Brown Bowel Syndrome)

6.15.Myasthenia Gravis

6.16.Myotonic Dystrophy

6.17.Hyperthyroidism and Hypothyroidis

6.18.Hyperparathyroidism

6.19.Uremia

6.20.Diabetes Mellitus

6.21.Wegener's Granulomatosis

6.22.Hepatolenticular Degeneration (Wilson's Disease)

7.1.Gastroesophageal Reflux Disease, Reflux Esophagitis, and Esophageal Ulcer

7.2.Corrosive Esophagitis

7.3.Iatrogenic Esophagitis

7.4.Exfoliative Esophagitis

7.5.Decubital Ulcer

7.6.Acute Necrotizing Esophagitis, Black Esophagus

7.7.Esophageal Phlegmon

7.8.GERD, Esophagitis, and Barrett's Esophagus Caused by Food Stasis Resulting from Kyphosis

8.1.Thermal Burn

8.2.Frostbite of the Esophagus

8.3.Foreign Body

8.4.Spontaneous Rupture

8.5.Mallory-Weiss Syndrome

8.6.Intramural Hematoma

8.7.Trauma

8.8.Esophageal Diverticula

8.9.Esophageal Webs

8.10.Lower Esophageal Ring (Schatzki's Ring)

8.11.Esophageal Mucosal Bridge

8.12.Aortoesophageal Fistula

8.13.Hairy Esophagus

8.14.Other Miscellaneous Disorders

9.1.Retention Cyst

9.2.Lymphoepithelial Cyst

9.3.Esophageal Acanthosis Nigricans

9.4.Esophageal Manifestations of Cowden's Disease(Multiple Hamartoma Syndrome)

9.5.Squamous Papillom

9.6.Hyperplastic Polyp of Ectopic Gastric Mucosa in the Cervical Esophagus

9.7.Adenoma

10.1.Xanthoma of the Esophagus

10.2.Reflux Gastroesophageal Polyp and Inflammatory Reflux Polyp

10.3.Inflammatory Fibroid Polyp, Inflammatory Fibrous Polyp, and Inflammatory Pseudotumor

10.4.Pyogenic Granuloma of the Esophagus

10.5.Fibrovascular Polyp

10.6.Hamartomatous Polyp

10.7.Pseudomalignant Erosive and Ulcerative Lesion

10.8.Leiomyoma

10.9.Diffuse Leiomyomatosis of the Esophagus and Idiopathic Muscular Hypertroph

10.10.Lipoma

10.11.Hemangioma

10.12.Lymphangioma

10.13.Granular Cell Tumor

10.14.Adult Rhabdomyoma

10.15.Osteochondrom

10.16.Glomus Tumor

10.17.Neurogenic Tumors

10.18. Calcifying Fibrous Pseudotumor

11.1.Location of Tumors Reported in Japan

11.2.Macroscopic Classification of Malignant Esophageal Neoplasms

11.3.Histologic Classification of Esophageal Neoplasms

11.4.Histological Subclassification of Invasion Depth by Superficial Carcinoma

11.5.Histological Staging of Malignant Esophageal Neoplasms

11.6.Esophageal Carcinoma in Children and Adolescents

12.1.Squamous Epithelial Dysplasia

12.2.Squamous Cell Carcinoma

12.3.Endocytoscopic Observation of Squamous Epithelium and Squamous Cell Carcinoma of the Esophagus

12.4.Microvascular Pattern and Invasion Depth by Squamous Cell Carcinoma

13.1.Barrett's Esophagus

13.2.Primary Adenocarcinoma of the Esophagus

14.1.Adenosquamous Carcinoma (Coexistence of Adenocarcinoma and Squamous Cell Carcinoma)

14.2.Mucoepidermoid Carcinoma

14.3.Adenoid Cystic Carcinoma

14.4.Undifferentiated Carcinoma

14.5.Basaloid Squamous Carcinoma and Basaloid Carcinoma

14.6.Other Tumor Types

15.1.Leiomyosarcoma

15.2.Non‐Hodgkin's Lymphoma and Leukemia

15.3.Hodgkin's Disease

15.4.Extramedullary Plasmacytoma of the Esophagus

15.5.Malignant Granular Cell Tumor

15.6.Malignant Neurogenic Tumor

15.7.Liposarcom

15.8.Angiogenic Sarcoma

15.9.Rhabdomyosarcoma

15.10.Osteosarcoma

15.11.Kaposi's Sarcoma

15.12.Synovial Sarcoma

15.13.Malignant Triton Tumor

15.14.Gastrointestinal Stromal Tumor

15.15.Fibrosarcoma

15.16.Malignant Rhabdoid Tumor

15.17.Extraskeletal Ewing's Sarcoma

15.18.Histiocytic Sarcoma

15.19.Malignant Glomus Tumor of the Esophagus

15.20.Epithelioid sarcoma

16.1.Carcinosarcoma and Pseudosarcoma

16.2.Macroscopic Features

16.3.Microscopic Features

16.4.Cytological Features

16.5.Ultrastructural Features

17.1.Primary Malignant Melanoma of the Esophagus

17.2.Metastatic Melanoma

17.3.Anthracosis of the Esophagus

19.1.Surgically Resected Specimens

19.2.Endoscopically Resected Specimens