Pancreatic acinar metaplasia in the distal oesophagus and the gastric cardia: prevalence, predictors and relation to GORD

Johansson, Johan; Håkansson, Hans-Olof; Mellblom, Lennart; Kempas, Antti; Kjellén, Gerhard; Brudin, Lars; Granath, Fredrik; Johansson, Karl‐Erik; Nyrén, Olof

doi:10.1007/s00535-009-0161-4

Cited by 16 publications

(15 citation statements)

References 18 publications

(44 reference statements)

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“…The latter has been supported by the fact that the embryonic esophagus is lined by columnar epithelium [9,10]. Furthermore, pancreatic acinar metaplasia at the GEJ is a relatively common finding, but the causative relationship between GERD and pancreatic acinar metaplasia is obscure [11]. Likewise, our patient presented with a finding of unclear origins, demonstrating the relevance of keeping salivary metaplasia in the differential and the importance of further investigations.…”

Section: Discussionsupporting

confidence: 58%

Salivary Gland Choristoma: A Rare Finding at the Gastroesophageal Junction

Hanke

Comba

Henriquez

et al. 2020

Cureus

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Section: Discussionsupporting

confidence: 58%

Salivary Gland Choristoma: A Rare Finding at the Gastroesophageal Junction

Hanke

Comba

Henriquez

et al. 2020

Cureus

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“…Its incidence ranges from 9% to 24% in biopsies [2,[4][5][6] and 30% to 61% in surgical resection specimens [3,7]. Similar to pancreatic exocrine glands, PAM glandular cells feature uniformly round to oval nuclei with basophilic cytoplasm in the basal compartment and eosinophilic cytoplasm in the apical compartment.…”

Section: Introductionmentioning

confidence: 97%

“…Some investigators believe PAM to be congenital in nature [2,14] or related to aging [6]. There is a theoretical possibility that gastroesophageal reflux disease and Barrett esophagus can be exacerbated by the pancreatic enzymes secreted by PAM glands [4,10].…”

Section: Introductionmentioning

confidence: 99%

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Pancreatic acinar-like adenocarcinoma of the proximal stomach invading the esophagus

et al. 2012

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“…One example is the recognition of small foci of pancreatic tissue found in the mucosa of the gastroesophageal junction in 5% to 16% of biopsies. 6,10,21 Another opportunity has emerged with the rediscovery of inflammatory polypoid lesions at the esophagogastric junction, known to some radiologists and endoscopists as the "sentinel fold" (Fig. 1A).…”

mentioning

confidence: 99%

Gastric Cardiac Polyps

Melton

Genta

2010

American Journal of Surgical Pathology

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As endoscopists have become more skilled in sampling the gastroesophageal junction, pathologists are being increasingly challenged to characterize previously unknown or neglected findings. One such example is the cardiac polyp. Originally described in the radiology literature as the sentinel fold, the first histologic descriptions of polyps at the gastroesophageal junction did not appear until less than a decade ago. Current clinicopathologic information is limited and somewhat conflicting. This study was designed to define the clinical, endoscopic, and histopathologic associations in patients with cardiac polyps. Using an electronic database, we extracted information on all patients who had a distal esophageal or esophagogastric junctional biopsy during a 24-month period. We then reviewed the slides of 330 adult patients diagnosed with a cardiac polyp and used semiquantitative or qualitative scales to score foveolar hyperplasia, inflammation, erosion or ulcers, epithelial type, and metaplasia. As controls we used 120,487 patients who had biopsies from the same anatomic sites during the same period, but were not diagnosed with a cardiac polyp. There were no significant differences among any clinical indications for esophagogastroduodenoscopy between study and control patients. Endoscopically, a polyp or nodule at the gastroesophageal junction was noted in 59.1% of the patients who had a histopathologic diagnosis of cardiac polyp. Histologically, Barrett mucosa, active esophagitis, and Helicobactor pylori gastritis were all significantly less common in patients with a cardiac polyp than in controls. Although relatively infrequent, synchronous hyperplastic polyps elsewhere in the stomach were significantly more common in patients than in controls. In conclusion, this large series suggests that cardiac polyps are rare but histologically distinct lesions. They are benign and are not uniquely associated with esophagitis, Barrett esophagus, gastroesophageal reflux disease, reactive gastropathy, or gastritis, with or without H. pylori.

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Pancreatic acinar metaplasia in the distal oesophagus and the gastric cardia: prevalence, predictors and relation to GORD

Abstract: Pancreatic acinar metaplasia might be an age-dependent lesion, associated with H. pylori, female gender and gastro-oesophageal reflux if located above the GOJ.

Cited by 16 publications

References 18 publications

Salivary Gland Choristoma: A Rare Finding at the Gastroesophageal Junction

Salivary Gland Choristoma: A Rare Finding at the Gastroesophageal Junction

Pancreatic acinar-like adenocarcinoma of the proximal stomach invading the esophagus

Gastric Cardiac Polyps

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