Immunohistochemistry of dysplasias and carcinomas of the esophageal epithelium.

Two types of high grade dysplasia were associated with invasive carcinomas. The first, deeply localized, had a pagetoid appearance and a particular phenotype: the dysplastic cells had keratins of low molecular weight rarely present in the esophagus; keratins of stratified epithelia were absent. This dysplasia was probably the origin of undifferentiated invasive carcinoma with which it was often associated. The second type, transepithelial, extended through the entire thickness of the epithelium. The abnormal cells presented some differentiation and stained positive for keratins of stratified epithelia. This dysplasia was often associated with differentiated squamous cell carcinoma. An intermediate-type dysplasia shared some characteristics with both main types. Several types of dysplasia and several areas of differently differentiated carcinoma were often associated in the same case. The evolutional potential of the different dysplasias is not known.