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Pathology of esophagus

Stephanie Posten, Tonya Adamiak, Melissa Jensen
Eosinophilic esophagitis (EoE) is a chronic immune-mediated esophageal inflammatory disease that is becoming more widely recognized as a cause of feeding difficulties in infants and young children, as well as gastroesophageal reflux disease (GERD)-like symptoms, dysphagia, and food impaction in children and adolescents. The diagnosis of EoE is clinicopathologic, based on endoscopic, histologic, and clinical findings. Patients with suspected eosinophilic esophagitis require an endoscopy with biopsies. The diagnosis requires the presence of 15 or more intraepithelial eosinophils/HPF in at least one endoscopic esophageal mucosal biopsy...
August 2018: South Dakota Medicine: the Journal of the South Dakota State Medical Association
F A Offner, C Langner
Heterotopia of the gastrointestinal tract is a common finding. This is due to the complex embryogenesis and the relative ease to detect heterotopic tissue during endoscopy. The reason for biopsy is mostly to rule out neoplasms or to define specific causes of inflammation. Heterotopic tissue can occur in any location of the gastrointestinal tract. The most frequent are gastric heterotopia, pancreatic heterotopia, and heterotopia of Brunner's gland. On rare occasions, heterotopic tissue of salivary gland type as well as heterotopias of apocrine glands, thyroid, and prostatic tissue have been described...
August 13, 2018: Der Pathologe
Frans van Workum, Annelijn E Slaman, Mark I van Berge Henegouwen, Suzanne S Gisbertz, Ewout A Kouwenhoven, Marc J van Det, Frits J H van den Wildenberg, Fatih Polat, Misha D P Luyer, Grard A P Nieuwenhuijzen, Camiel Rosman
INTRODUCTION: Totally minimally invasive esophagectomy (TMIE) is increasingly used in treatment of patients with esophageal carcinoma. However, it is currently unknown if McKeown TMIE or Ivor Lewis TMIE should be preferred for patients in whom both procedures are oncologically feasible. METHODS: The study was performed in 4 high-volume Dutch esophageal cancer centers between November 2009 and April 2017. Prospectively collected data from consecutive patients with esophageal cancer localized in the distal esophagus or gastroesophageal junction undergoing McKeown TMIE or Ivor Lewis TMIE were included...
August 10, 2018: Annals of Surgery
Hong Yang, Hui Liu, Yuping Chen, Chengchu Zhu, Wentao Fang, Zhentao Yu, Weimin Mao, Jiaqing Xiang, Yongtao Han, Zhijian Chen, Haihua Yang, Jiaming Wang, Qingsong Pang, Xiao Zheng, Huanjun Yang, Tao Li, Florian Lordick, Xavier Benoit D'Journo, Robert J Cerfolio, Robert J Korst, Nuria M Novoa, Scott J Swanson, Alessandro Brunelli, Mahmoud Ismail, Hiran C Fernando, Xu Zhang, Qun Li, Geng Wang, Baofu Chen, Teng Mao, Min Kong, Xufeng Guo, Ting Lin, Mengzhong Liu, Jianhua Fu
Purpose The efficacy of neoadjuvant chemoradiotherapy (NCRT) plus surgery for locally advanced esophageal squamous cell carcinoma (ESCC) remains controversial. In this trial, we compared the survival and safety of NCRT plus surgery with surgery alone in patients with locally advanced ESCC. Patients and Methods From June 2007 to December 2014, 451 patients with potentially resectable thoracic ESCC, clinically staged as T1-4N1M0/T4N0M0, were randomly allocated to NCRT plus surgery (group CRT; n = 224) and surgery alone (group S; n = 227)...
August 8, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Arvind Krishnamurthy, N Mohanraj, Venkataraman Radhakrishnan, Alexander John, G Selvaluxmy
BACKGROUND: The management of locally advanced carcinomas of the esophagus and esophagogastric junction has undergone a major evolution over the past two decades with the widespread use of combined modality therapy. Although many Indian centers practice the combined modality therapy with neoadjuvant chemoradiation (nCRT), published data are sparse. OBJECTIVES: The objective of this study was to study the safety and efficacy of nCRT in patients with locally advanced resectable carcinoma of the esophagus...
October 2017: Indian Journal of Cancer
Lawrence F Borges, Walter W Chan, Thomas L Carroll
BACKGROUND: Laryngopharyngeal reflux (LPR) is commonly treated with empiric acid suppression. More evidence points to pepsin in the pathophysiology of LPR. Previous studies have evaluated esophageal impedance in patients who had previously failed high dose proton pump inhibitor (PPI) using older catheters without proximal esophageal (just under the upper esophageal sphincter) and pharyngeal impedance sensors. The aim of this study was to compare what traditional diagnostic tools, used for esophageal reflux, would detect and diagnose compared with what a combined hypopharyngeal-esophageal MII catheter with dual pH (HEMII-pH) can detect in the esophagus and pharynx in patients with suspected LPR...
August 3, 2018: Journal of Voice: Official Journal of the Voice Foundation
Seung-Joo Nam, Hyun Seok Lee, Yun Jeong Lim
The clinical indication for capsule endoscopy has expanded from small bowel evaluation to include esophagus or colon evaluation.Nevertheless, the role of capsule endoscopy in evaluation of the stomach is very limited because of the large volume and surface.However, efforts to develop an active locomotion system for capsule manipulation in detailed gastric evaluation are ongoing, becausethe technique is non-invasive, convenient, and safe, and requires no sedation. Studies have successfully reported gastric evaluation usinga magnetic-controlled capsule endoscopy system...
July 2018: Clinical Endoscopy
Junseok Park, Young Kwan Cho, Ji Hyun Kim
Capsule endoscopy can be a diagnostic option for patients with esophageal diseases who cannot tolerate esophagogastroduodenoscopy.Functional modifications of the capsule allow for thorough examination of the esophagus. Esophageal capsule endoscopy has so farfailed to show sufficient performance to justify the replacement of traditional endoscopy for the diagnosis of esophageal diseasesbecause the esophagus has a short transit time and common pathologies appear near the esophagogastric junction. However,technological improvements are being introduced to overcome the limitations of capsule endoscopy, which is expected to become agood alternative to conventional endoscopy...
July 2018: Clinical Endoscopy
Dianna M E Bardo, Deepa R Biyyam, Mittun C Patel, Kevin Wong, Dane van Tassel, Ryan K Robison
The mediastinum, the central anatomical space of the thorax, is divided by anatomical landmarks but not by physical boundaries. The mediastinum is a conduit, a space through which cranial nerves, important nerve branches, the sympathetic chain, vascular structures, and visceral structures, the trachea and esophagus pass. This arrangement allows contiguous extension or communication of disease along facial planes and through potential spaces to and from the head and neck or cervical spine, to and from the superior mediastinum, between superior and inferior mediastinal levels, and between inferior mediastinal spaces into the intra- and retroperitoneal spaces...
August 2018: Pediatric Radiology
Krysta H Rogers, Yvette A Girard, Leslie W Woods, Christine K Johnson
Avian trichomonosis is an upper digestive tract disease of birds typically caused by the protozoan parasite Trichomonas gallinae . In California (U.S.A), trichomonosis is known to cause periodic epidemics in the Pacific Coast band-tailed pigeon ( Patagioenas fasciata monolis ), a migratory upland game bird. We summarize the mortality events that occurred during winter 2014-2015 including the duration, estimated mortality, pathology, and genetic identity of infecting parasites. Increased mortality was reported from locations in 25 counties between November 2014 and June 2015...
December 2018: International Journal for Parasitology. Parasites and Wildlife
Vincent M Pronesti, Kanika Goel, Marcia Mitre
This is the case of a 28-year-old female who presented with a complaint of dysphagia and was diagnosed with the rare disease of esophageal granular cell tumor (GCT) after esophagogastroduodenoscopy (EGD) and endoscopic ultrasound (EUS). The case acknowledges the wisdom of maintaining a broad differential for a common complaint. It also serves to reiterate the clinical and pathologic criteria for the diagnosis of a granular cell tumor of the esophagus.
May 23, 2018: Curēus
Umair Iqbal, Osama Siddique, Anais Ovalle, Hafsa Anwar, Steven F Moss
Esophageal adenocarcinoma is an increasingly common cause of morbidity and mortality in developed countries. Most cases are considered the consequence of chronic gastroesophageal reflux disease, with subsequent Barrett's metaplasia and dysplasia. Because progression from Barrett's metaplasia to cancer occurs over many years, endoscopic screening and surveillance programs have been established, albeit with little or no consideration for cost-effectiveness. As an alternative to the expensive and resource-demanding endoscopic surveillance, the Cytosponge has been developed to sample the esophageal mucosa efficiently...
July 23, 2018: European Journal of Gastroenterology & Hepatology
Michalina J Gora, Lucille Quénéhervé, Robert W Carruth, Weina Lu, Mireille Rosenberg, Jenny S Sauk, Alessio Fasano, Gregory Y Lauwers, Norman S Nishioka, Guillermo J Tearney
BACKGROUND: Patients with many different digestive diseases undergo repeated esophagogastroduodenoscopy throughout their life. Tethered capsule endomicroscopy (TCE) is a less invasive method for obtaining high-resolution images of the gastrointestinal mucosa for diagnosis and treatment planning of diseases. In this paper, we present our results from a single center, aimed at testing the safety and the feasibility of TCE for imaging the esophagus, stomach, and duodenum. METHODS: After swallowed by an unsedated subject, the tethered capsule obtains cross-sectional 10-μm-resolution optical coherence tomography images as the device traverses the alimentary tract...
July 19, 2018: Gastrointestinal Endoscopy
M J van der Wel, L C Duits, E Klaver, R E Pouw, C A Seldenrijk, Gja Offerhaus, M Visser, Fjw Ten Kate, J G Tijssen, Jjghm Bergman, S L Meijer
Background: Dysplasia in Barrett's esophagus (BE) biopsies is associated with low observer agreement among general pathologists. Therefore, expert review is advised. We are developing a web-based, national expert review panel for histological review of BE biopsies. Objective: The aim of this study was to create benchmark quality criteria for future members. Methods: Five expert BE pathologists, with 10-30 years of BE experience, weekly handling 5-10 cases (25% dysplastic), assessed a case set of 60 digitalized cases, enriched for dysplasia...
July 2018: United European Gastroenterology Journal
Ashok Keshav Rathod, Rakesh Padmakar Dhake, Mohit Navinchand Muttha, Amit Indrasan Singh, Dattatray Vilas Thakur
Objective/Purpose: The objective of this study is to describe our experience with the use of stay sutures and transverse neck incision for anterior cervical spine surgeries involving multiple levels. Summary of Background Data: Transverse incisions on neck usually heal with minimal fibrosis resulting in cosmetically acceptable scars whereas vertical incision, although provides greater exposure, heals with extensive fibrosis resulting in ugly scars. Transverse incision is thus highly recommended...
April 2018: Journal of Craniovertebral Junction and Spine
S P Tang, Y L Liu, H Gao, L Dong, D R Lin, S Chen, D Y Zhang, L L Zhang, J Pan
Objective: To explore the correlation between the severity of gastroesophageal reflux cough and degree of gastroesophageal reflux. Methods: A cross-sectional investigation was carried out. Data of 174 cases of chronic cough were collected in Children's Hospital of Fuzhou from March 2009 to December 2016. The esophageal 24 hours pH value dynamic monitoring was used to detect gastric acid reflux index. Cases with abnomal results were divided into mild, moderate and severe groups according to severity of reflux and that of day and night cough symptoms, respectively...
July 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
X X Han, D X Guan, J Zhou, F H Yu, G L Wang, T L Mei, S Guo, L B Fu, J Zhang, H Q Shen, X W Xu
Objective: To summarize the clinical data including manifestations, diagnosis, treatment and prognosis of eosinophilic gastroenteritis (EGE) in children. Methods: A retrospective analysis was performed in 71 patients with pathologically proven EGE at Beijing Children's Hospital Affiliated to Capital Medical University from January 2008 to January 2017. Their clinical manifestations, laboratory and imaging examinations, endoscopic findings, histopathological examinations, and treatment were collected and analyzed...
July 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Syed Nusrath, Subramanyeshwar Rao Thammineedi, K V Vijaya Narsimha Raju, Sujit Chyau Patnaik, Satish Pawar, Ayyagari Santa, Senthil J Rajappa, Krishna Mohan Mallavarapu, Krishnam Raju, Sudha Murthy, D N B Pathology
BACKGROUND: Neoadjuvant chemotherapy (NACT) and neoadjuvant chemoradiotherapy (NACRT) have been demonstrated to improve survival compared to surgery alone in esophageal carcinoma, but the evidence is scarce on which of these therapies is more beneficial, particularly with regard to resectability rates, postoperative morbidity and mortality, and histological responses. OBJECTIVE: This study compares the resectability, pathological response rates, and short-term surgical outcomes in patients with carcinoma of the esophagus or gastroesophageal junction receiving NACT or NACRT prior to surgery...
July 9, 2018: Rambam Maimonides Medical Journal
Pave Markoš, Iva Brčić, Luka Brčić, Jasminka Jakić-Razumović, Roland Pulanić
AIM: To analyze the loss of mismatch repair (MMR) system protein expression in metaplasia-dysplasia-adenocarcinoma sequence of Barrett esophagus (BE). METHODS: This study retrospectively analyzed the data from 70 patients with pathohistological diagnosis of BE or esophageal adenocarcinoma (EAC) treated at the Clinical Department of Pathology and Cytology, University Hospital Center Zagreb, from January 2009 to January 2011. Patients were divided into three groups: BE without dysplasia (22 patients), BE with dysplasia (37 patients), and EAC (11 patients)...
June 30, 2018: Croatian Medical Journal
Aleksandra M Urbanska, Selvarangan Ponnazhagan, Masoud Mozafari
Despite esophageal adenocarcinoma (EAC) being the most widespread among gastrointestinal cancers, with an 11-fold increase in the risk of cancer for patients with Barrett esophagus (BE), its prognosis is still poor. There is a critical need to better perceive the biology of cancer progression and identification of specific targets that are the hallmark of BE's progression. This review explores the established animal models of BE, including genetic, surgical and nonsurgical approaches, potential chemoprevention targets, and the reasoning behind their applications to prevent Barrett-related EAC...
July 15, 2018: Cancer Research
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