- Published on
Pathology - Oesophagitis
Definition • Inflammation of the esophagus.
Presentation • Retrosternal burning sensation (heartburn). • Dysphagia and singultus may also manifest.
Reflux oesophagitis • Induced by gastric acid refluxing into the lower oesophagus. • Highly prevalent. Predominantly observed in adult Caucasian males, though it can manifest in individuals of any gender, race, and age, including children. • Contributing factors encompass alcohol consumption, pharmacological agents, hypothyroidism, pregnancy, hiatal hernia, diabetes, and obesity. • Mucosal biopsy reveals regenerative alterations in the squamous epithelium, characterized by basal cell hyperplasia and the extension of vascular papillae into the upper epithelial layers. Inflammation is often modest with dispersed eosinophils. Approximately 10% of patients exhibit glandular metaplasia of the lower esophagus, identifiable during endoscopy (Barrett's esophagus). Two Barrett's oesophagus is linked to a 50-fold heightened incidence of oesophageal cancer.Individuals diagnosed with Barrett’s oesophagus ought to be evaluated for participation in a monitoring program involving routine endoscopy and biopsy to assess for glandular epithelial dysplasia.
Drug-induced (pill) esophagitis • Resulting from the direct toxicity of medications to the esophageal mucosa. • Predominantly affects the elderly population. • Frequently implicated medications include bisphosphonates and iron supplements. Mucosal biopsy reveals acute inflammation accompanied by erosion or ulceration of the surface epithelium. Encrusted golden brown iron pigment may be observed in instances attributed to iron tablets. Typically, this condition resolves following the cessation of the implicated medication.
Eosinophilic esophagitis • A rare disorder predominantly affecting atopic persons with a history of allergies, asthma, and medication sensitivities. • Mucosal biopsy reveals significant infiltration of eosinophils in the mucosa, typically forming clusters. • Favorable prognosis if discovered and treated promptly. If left untreated, it may result in significant oesophageal strictures.
Infectious esophagitis • Primarily observed in immunocompromised individuals, as the esophagus typically exhibits significant resistance to infection. • Mucosal biopsy reveals inflammation alongside pseudohyphae in Candida, multinucleation, and chromatin margination in herpes simplex, as well as inclusions in cytomegalovirus.
Definition • Inflammation of the esophagus.
Presentation • Retrosternal burning sensation (heartburn). • Dysphagia and singultus may also manifest.
Reflux oesophagitis • Induced by gastric acid refluxing into the lower oesophagus. • Highly prevalent. Predominantly observed in adult Caucasian males, though it can manifest in individuals of any gender, race, and age, including children. • Contributing factors encompass alcohol consumption, pharmacological agents, hypothyroidism, pregnancy, hiatal hernia, diabetes, and obesity. • Mucosal biopsy reveals regenerative alterations in the squamous epithelium, characterized by basal cell hyperplasia and the extension of vascular papillae into the upper epithelial layers. Inflammation is often modest with dispersed eosinophils. Approximately 10% of patients exhibit glandular metaplasia of the lower esophagus, identifiable during endoscopy (Barrett's esophagus). Two Barrett's oesophagus is linked to a 50-fold heightened incidence of oesophageal cancer.Individuals diagnosed with Barrett’s oesophagus ought to be evaluated for participation in a monitoring program involving routine endoscopy and biopsy to assess for glandular epithelial dysplasia.
Drug-induced (pill) esophagitis • Resulting from the direct toxicity of medications to the esophageal mucosa. • Predominantly affects the elderly population. • Frequently implicated medications include bisphosphonates and iron supplements. Mucosal biopsy reveals acute inflammation accompanied by erosion or ulceration of the surface epithelium. Encrusted golden brown iron pigment may be observed in instances attributed to iron tablets. Typically, this condition resolves following the cessation of the implicated medication.
Eosinophilic esophagitis • A rare disorder predominantly affecting atopic persons with a history of allergies, asthma, and medication sensitivities. • Mucosal biopsy reveals significant infiltration of eosinophils in the mucosa, typically forming clusters. • Favorable prognosis if discovered and treated promptly. If left untreated, it may result in significant oesophageal strictures.
Infectious esophagitis • Primarily observed in immunocompromised individuals, as the esophagus typically exhibits significant resistance to infection. • Mucosal biopsy reveals inflammation alongside pseudohyphae in Candida, multinucleation, and chromatin margination in herpes simplex, as well as inclusions in cytomegalovirus.
0 Comments
