Epidermoid metaplasia of the esophagus: endoscopic feature and differential diagnosis.
Epidermoid metaplasia of the esophagus: endoscopic feature and differential diagnosis.
复制标题
DOI：
--
复制
发表时间：
2011-05
影响因子：
--
通讯作者：
Yasumasa Ezoe;S. Fujii;M. Muto;A. Ochiai;A. Ohtsu
中科院分区：
文献类型：
--
作者：
Yasumasa Ezoe;S. Fujii;M. Muto;A. Ochiai;A. Ohtsu
背景/目的尽管最近内窥镜诊断的准确性有所提高，但胃肠道中仍然存在许多未被发现的病变。一种这样的病变是食管的表皮样化生。本研究的目的是阐明食管表皮样化生的内镜和病理特征。方法 我们回顾了 2003 年 9 月至 2006 年 8 月在我们机构获得的胃肠道内镜活检标本的所有组织学记录，并从 4 名患者中发现了 5 个具有表皮样化生特征性病理结果的病变。结果 所有四名患者均为酗酒者，并患有同步或异时鳞状细胞癌。其中三人的背景食管粘膜有多个卢戈排空病变。内镜检查显示这些病变的共同特征是：边界清晰，形状稍隆起，呈半透明白色，表面有鳞屑或毛茸茸的，卢戈氏碘染色后外观未染色。这些内窥镜检查结果类似于浅表食管癌。这些病变的病理特征是角化过度、上皮颗粒层明显，与正常皮肤表皮非常相似。结论 由于表皮样化生的内镜特征与浅表性食管癌相似，因此内镜检查时必须对这一新实体给予足够的重视。
BACKGROUND/AIMS Despite the recent improvement of endoscopic diagnostic accuracy, there remain many undiscovered lesions in the GI tract. One such lesion is epidermoid metaplasia of the esophagus. The aim of this study is to clarify the endoscopic and pathological characteristics of epidermoid metaplasia of the esophagus. METHODOLOGY We reviewed all histological records of gastrointestinal endoscopic biopsy specimens obtained in our institution from September 2003 to August 2006 and identified five lesions from four patients with characteristic pathological findings of epidermoid metaplasia. RESULTS All four patients were heavy drinkers and had a synchronous or metachronous squamous cell carcinoma. Three of them had multiple lugol-voiding lesions in the background esophageal mucosa. Endoscopic examination revealed common findings in these lesions: clear demarcation, slightly elevated shape, translucent white color, scaly or shaggy surface, and unstained appearance after Lugol's iodine staining. These endoscopic findings resembled those of superficial esophageal cancer. The pathological features of these lesions were uniform in hyperkeratotic and distinct granular layers of the epithelium and were very similar to those of normal epidermis of the skin. CONCLUSIONS Since the endoscopic features of epidermoid metaplasia resemble those of superficial esophageal cancer, we must pay enough attention to this new entity at the endoscopic examination.