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Difference between revisions of "Eosinophilic esophagitis"
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Eosinophilic esophagitis (view source)
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| Caption = Eosinophilic esophagitis. [[H&E stain]]. | | Caption = Eosinophilic esophagitis. [[H&E stain]]. | ||
| Micro = mucosa with abundant eosinophils (60 per mm*mm), [[basal cell hyperplasia]] (three cells thick ''or'' >15% of epithelial thickness), papillae elongated (reach into the top 1/3 of the epithelial layer) | | Micro = mucosa with abundant eosinophils (60 per mm*mm), [[basal cell hyperplasia]] (three cells thick ''or'' >15% of epithelial thickness), papillae elongated (reach into the top 1/3 of the epithelial layer) | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[GERD]] | | LMDDx = [[GERD]] | ||
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==Gross/endoscopic== | ==Gross/endoscopic== | ||
*'''Trachealization'''; | *'''Trachealization'''; esophagus looks like trachea.<ref name=pmid19636182>{{Cite journal | last1 = Al-Hussaini | first1 = AA. | last2 = Semaan | first2 = T. | last3 = El Hag | first3 = IA. | title = Esophageal trachealization: a feature of eosinophilic esophagitis. | journal = Saudi J Gastroenterol | volume = 15 | issue = 3 | pages = 193-5 | month = | year = | doi = 10.4103/1319-3767.54747 | PMID = 19636182 }} | ||
</ref> | </ref> | ||
**[[AKA]] ''feline esophagus''.<ref>URL: [http://www.ajronline.org/cgi/reprint/164/4/900.pdf http://www.ajronline.org/cgi/reprint/164/4/900.pdf]. Accessed on: 4 October 2010.</ref> | **[[AKA]] ''feline esophagus''.<ref>URL: [http://www.ajronline.org/cgi/reprint/164/4/900.pdf http://www.ajronline.org/cgi/reprint/164/4/900.pdf]. Accessed on: 4 October 2010.</ref> | ||
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==Microscopic== | ==Microscopic== | ||
Features:<ref name=Ref_GLP19>{{Ref GLP|19}}</ref> | Features:<ref name=Ref_GLP19>{{Ref GLP|19}}</ref> | ||
*Mucosa with | *Mucosa with abundant eosinophils - the consensus on eosinophils per area is 60/mm*mm.<ref name=pmid30009819>{{cite journal |authors=Dellon ES, Liacouras CA, Molina-Infante J, Furuta GT, Spergel JM, Zevit N, Spechler SJ, Attwood SE, Straumann A, Aceves SS, Alexander JA, Atkins D, Arva NC, Blanchard C, Bonis PA, Book WM, Capocelli KE, Chehade M, Cheng E, Collins MH, Davis CM, Dias JA, Di Lorenzo C, Dohil R, Dupont C, Falk GW, Ferreira CT, Fox A, Gonsalves NP, Gupta SK, Katzka DA, Kinoshita Y, Menard-Katcher C, Kodroff E, Metz DC, Miehlke S, Muir AB, Mukkada VA, Murch S, Nurko S, Ohtsuka Y, Orel R, Papadopoulou A, Peterson KA, Philpott H, Putnam PE, Richter JE, Rosen R, Rothenberg ME, Schoepfer A, Scott MM, Shah N, Sheikh J, Souza RF, Strobel MJ, Talley NJ, Vaezi MF, Vandenplas Y, Vieira MC, Walker MM, Wechsler JB, Wershil BK, Wen T, Yang GY, Hirano I, Bredenoord AJ |title=Updated International Consensus Diagnostic Criteria for Eosinophilic Esophagitis: Proceedings of the AGREE Conference |journal=Gastroenterology |volume=155 |issue=4 |pages=1022–1033.e10 |date=October 2018 |pmid=30009819 |pmc=6174113 |doi=10.1053/j.gastro.2018.07.009 |url=}}</ref> | ||
*[[Basal cell hyperplasia]]. | *[[Basal cell hyperplasia]]. | ||
**Three cells thick ''or'' >15% of epithelial thickness. | **Three cells thick ''or'' >15% of epithelial thickness. | ||
*Papillae elongated. | *Papillae elongated. | ||
**Papillae that reach into the top 1/3 of the epithelial layer - definition for GERD.<ref name=Ref_PBoD804>{{Ref PBoD|804}}</ref> | **Papillae that reach into the top 1/3 of the epithelial layer - definition for GERD.<ref name=Ref_PBoD804>{{Ref PBoD|804}}</ref> | ||
Note: | |||
*Many microscopes have an eye piece diameter of 22 mm. Thus, the field area (for a "HPF") with the 40x objective is ~0.2376 mm*mm. This works out to approximately 15 eosinophils/HPF. | |||
DDx:<ref name=Ref_Odze244>{{Ref Odze|244}}</ref> | DDx:<ref name=Ref_Odze244>{{Ref Odze|244}}</ref> | ||