Korean J Gastrointest Endosc.  2011 Mar;42(3):143-151.

Analysis of the Clinicopathologic Features of Eosinophilic Esophagitis: Comparative Study with Nonobstructive Dysphagia

Affiliations
  • 1Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 2Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. SOYOON@yuhs.ac

Abstract

BACKGROUND/AIMS
Eosinophilic esophagitis (EoE) has emerged as one of the most common causes of dysphagia and esophageal food impactions. However, it is doubtful that gastroenterologists and pathologists make the correct diagnosis of EoE because of the insufficient recognition of EoE based on the endoscopic and pathological findings. This study was performed to investigate the symptoms and the endoscopic and pathologic findings of EoE as compared with those of nonobstructive dysphagia (NOD).
METHODS
We retrospectively reviewed the medical records and the endoscopic and pathologic findings from 12 patients who were diagnosed with EoE based on an eosinophil count of > or =20 per high-power field (HPF) and 13 patients diagnosed with NOD, and these patients were treated at our hospital from June 2006 till October 2010.
RESULTS
The endoscopic findings of EoE included rings (41.7%), furrows (75.0%), exudates (33.3%), mucosal friability (8.3%) and multi-findings (6.7%). Furrows and multi-findings were identified more frequently in EoE as comparison to that in NOD. The pathologic findings revealed that the maximal eosinophil counts/HPF were 87.2 (range 20~232) and 2.2 (0~1) in EoE and NOD, respectively. Moreover, eosinophil microabscess (58.3%), degranulation (100%) and spongiosis (91.7%) were more significantly observed in EoE compared with that in NOD.
CONCLUSIONS
EoE had specific endoscopic and clinicopathologic features that distinguish it from NOD. For patients with dysphagia, the endoscopic and pathologic findings of EoE should be kept in mind.

Keyword

Eosinophilic esophagitis; Nonobstructive dysphagia; Pathologic finding; Endoscopic finding

MeSH Terms

Deglutition Disorders
Eosinophilic Esophagitis
Eosinophils
Exudates and Transudates
Humans
Medical Records
Retrospective Studies
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