Pathology of oesophagitis

Abstract

Endoscopic oesophageal biopsies are common in daily pathology practice. Inflammation and damage of the oesophageal mucosa is known as oesophagitis and is common worldwide. A variety of physical, chemical and infectious agents cause oesophagitis. The oesophagus has a limited range of responses to a wide variety of injuries, and so histopathological features of different diseases often overlap. The pathologist is reliant on the endoscopist for the 'macroscopic description' of the oesophagus. Access to the endoscopic images enhances the pathologist's overall interpretation of the case. Correlating clinical, endoscopic and microscopic findings may be crucial in arriving at the correct diagnosis. In this review, we present clinicopathological descriptions of the major types of oesophagitis.

Destruction of the Dorsal Motor Nucleus of the Vagus Aggravates Inflammation and Injury from Acid-Induced Acute Esophagitis in a Rat Model

“…The extent of microscopic mucosal damage was determined and graded by two independent observers who were unaware of the treatment given. The scoring criteria for esophagitis were modified in the past literature [14] as follows: epithelial changes (basal hyperplasia, mitosis, papillomatosis, epithelial splitting, erosion, and ulceration), maximal score 40; inflammation (intraepithelial leukocytes, intensity, and extension), maximal score 40; and vascular alterations (edema, congestion, and hemorrhage), maximal score 20. The remaining esophageal tissue was preserved in liquid nitrogen.…”

Esophagitis: Old Histologic Concepts and New Thoughts

“…In some patients, the Candida infection may be opportunistic, infecting areas of inflammation and ulceration from other causes. 37,38 Cytologic brushings can be more useful than biopsies in the setting of Candida infection, where it has the same appearance as on Papanicolaou tests. 37 On biopsies, a pattern of acute inflammation and reactive changes is seen.…”

“…Immunohistochemistry for these viruses can be useful if the viral inclusions are not readily identified (Figure 5, D). 38…”

Esophageal introitus (with videos)

“…57 Infectious esophagitis generally develops in immunocompromised patients, with candidiasis being the most common infection. [58][59][60][61][62] Less-common infections include herpes simplex and cytomegalovirus esophagitis. [58][59][60] When obtaining tissue diagnosis, physicians should ensure that biopsy specimens are taken from both the ulcer edge and base.…”