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2 results

  • Chapter 12 - Assessment of Gastric Biopsies

  • Edited by Roger M. Feakins
  • Book:
    Non-Neoplastic Pathology of the Gastrointestinal Tract
    Published online:
    06 June 2020
    Print publication:
    09 July 2020, pp 179-185

  • Summary

    The recognition of specific oesophageal infections and the distinction between gastro-oesophageal reflux disease and rarer forms of oesophagitis are key tasks for gastrointestinal pathologists reading mucosal biopsies. Infections can involve the oesophagus either primarily or as part of a wider process. This chapter highlights their features, discussing in detail the common infections including herpes simplex, cytomegalovirus, and Candida, and summarises the features of the rarer ones. A few additional types of oesophagitis have emerged recently, including eosinophilic oesophagitis and lymphocytic oesophagitis. This chapter reviews the recent literature and will discuss the controversies surrounding some of these new entities. There is an emphasis on the need for correlation between clinical/endoscopic information and microscopic appearances, and there is discussion of supplementary special studies including immunohistochemistry where relevant.

  • Paediatric eosinophilic oesophagitis presenting to the otolaryngologist

  • R Harris, S Mitton, S Chong, H Daya
  • Journal:
    The Journal of Laryngology & Otology / Volume 124 / Issue 1 / January 2010
    Published online by Cambridge University Press:
    30 July 2009, pp. 96-100
    Print publication:
    January 2010
  • Introduction:

    The prevalence of eosinophilic oesophagitis is increasing. A Pubmed search for ‘eosinophilic oesophagitis’ and ‘eosinophilic esophagitis’ yielded 345 publications since 1976. Only seven were in otolaryngology journals.1–7 Patients typically present with dysphagia, vomiting, dyspepsia or food impaction and are therefore usually referred to a paediatric gastroenterologist; otolaryngologists are not usually involved in management. A missed diagnosis may result in oesophageal stricture.

    Methods:

    Two patients, aged two and four years, were referred to the paediatric otolaryngology department with intermittent upper oesophageal food impaction. A paediatric gastroenterologist was involved in the investigation. Histological examination of oesophageal biopsies demonstrated changes consistent with eosinophilic oesophagitis.

    Results:

    Both patients were expediently diagnosed, investigated and managed.

    Conclusion:

    A diagnosis of eosinophilic oesophagitis must be considered in patients presenting with food bolus impaction. Early involvement of a paediatric gastroenterology team in the diagnosis is recommended in children presenting with oesophageal symptoms, in order to avoid delayed diagnosis.