Eosinophilic esophagitis, Nonobstructive dysphagia, Pathologic finding, Endoscopic finding"/>
Analysis of the Clinicopathologic Features of Eosinophilic Esophagitis: Comparative Study with Nonobstructive Dysphagia
Korean Journal of Gastrointestinal Endoscopy 2011;42(3): 143-151.
호산구 식도염의 임상병리학적 특징 분석: 비폐쇄성 연하곤란과의 비교 연구
김광현ㆍ정일형ㆍ김지현ㆍ윤영훈ㆍ윤선옥*ㆍ박효진ㆍ이상인
연세대학교 의과대학 강남세브란스병원 소화기내과학교실, *병리학교실
Analysis of the Clinicopathologic Features of Eosinophilic Esophagitis: Comparative Study with Nonobstructive Dysphagia
Kwang Hyun Kim, M.D., Il Hyung Chung, M.D., Jie-Hyun Kim, M.D., Young Hoon Youn, M.D., Sun Och Yoon, M.D.*, Hyojin Park, M.D. and Sang In Lee, M.D.
Departments of Internal Medicine and *Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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 ≥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∼11) 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. (Korean J Gastrointest Endosc 2011;42:143-151)
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