Lymphadenopathy
Lymphatic spread occurs through the lymphatic vessels, depending on the location of the esophageal tumor. If the carcinoma is present in the cervical part of the esophagus, metastasis to deep cervical lymph nodes can occur. The thoracic part might metastasize to the posterior mediastinal lymph nodes, and the abdominal masses metastasizes to gastric lymph nodes or coeliac lymph nodes.
Other lymph nodes that may be involved are supraclavicular and para tracheobronchial lymph nodes. Spread through sub mucosal lymphatics is also possible, which can produce skip lesions seen on esophagoscopy. These are described as patches of mucosa affected by the tumor skipping unaffected areas in between.