Esophagus, Eosinophilic esophagitis [LMP44734]

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Diagnostic Modality: 
Whole Slide Image
Disease Category: 
Acute and Chronic Inflammation
Diagnosis: 
Eosinophilic esophagitis
Species: 
Human
Organ System: 
Gastrointestinal Tract
Gender: 
Male
Age: 
41 years
Diagnosis Code: 
ICD-10: K20
Slide Contributor Information
Yang, H., Hsieh, E.

Keywords

Esophagus, esophagitis

Clinical History

History of food bolus and dysphagia. OGD demonstrates "trachealization" of the esophagus. Biopsy of the proximal esophagus.

Clinical Discussion

Eosinophilic esophagitis is a form of esophagitis characterized by an abundance of intraepithelial eosinophils. It affects both children and adults and is believed to be an allergic disorder. Clinically, the predominant symptom is dysphagia and there is an association with atopy, asthma, allergic rhinitis, and peripheral blood eosinophilia. On endoscopy, patients with eosinophilic esophagitis demonstrate characteristic esophageal rings referred to as "trachealization" of the esophagus.

The microscopic findings may overlap with Gastroesophageal Reflux Disease (GERD), however eosinophilic esophagitis characteristically demonstrates a greater degree of intraepithelial eosinophils (typically >15/HPF) and greater severity within the proximal esophagus. The eosinophils are typically found within the superficial portions of the squamous mucosa and may aggregate to form eosinophilic microabscesses.

Alterations to diet and corticosteroids, either topical or systemic, may be required to treat eosinophilic esophagitis.