Difference between revisions of "Glycogenic acanthosis of the esophagus"

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{{ Infobox diagnosis
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Name      = {{PAGENAME}}
| Image      =  
| Image      = Acanthosis_and_superficial_clearing_of_the_esophagus_-_alt_--_intermed_mag.jpg
| Width      =
| Width      =
| Caption    =  
| Caption    = Glycogenic acanthosis of the esophagus. [[H&E stain]].
| Synonyms  =
| Synonyms  =
| Micro      = squamous epithelium with (1) superficial clearing of the cytoplasm, and (2) thickening
| Micro      = squamous epithelium with (1) superficial clearing of the cytoplasm, and (2) thickening
| Subtypes  =
| Subtypes  =
| LMDDx      =
| LMDDx      =
| Stains    =
| Stains    = PAS +ve, PASD -ve
| IHC        =
| IHC        =
| EM        =
| EM        =
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| Grossing  =
| Grossing  =
| Site      = [[esophagus]]
| Site      = [[esophagus]]
| Assdx      = [[gastroesophageal reflux disease]] (???)
| Assdx      = possibly associated with [[gastroesophageal reflux disease]]
| Syndromes  =
| Syndromes  = possibly [[Cowden's disease]] when diffuse
| Clinicalhx = ingestion of hot liquids (???)
| Clinicalhx = ingestion of hot liquids (???)
| Signs      =
| Signs      =
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| Tx        =
| Tx        =
}}
}}
'''Glycogenic acanthosis of the esophagus''' is an uncommon benign change of the [[esophagus]] with a distinctive endoscopic appearance.
'''Glycogenic acanthosis of the esophagus''', abbreviated '''GAE''', is an uncommon benign change of the [[esophagus]] with a distinctive endoscopic appearance.


==General==
==General==
*Uncommon - seen 3.5% of consecutive 2328 upper endoscopies.<ref name=pmid8409304>{{Cite journal  | last1 = Vadva | first1 = MD. | last2 = Triadafilopoulos | first2 = G. | title = Glycogenic acanthosis of the esophagus and gastroesophageal reflux. | journal = J Clin Gastroenterol | volume = 17 | issue = 1 | pages = 79-83 | month = Jul | year = 1993 | doi =  | PMID = 8409304 }}</ref>
*Uncommon - seen 3.5% of consecutive 2328 upper endoscopies.<ref name=pmid8409304>{{Cite journal  | last1 = Vadva | first1 = MD. | last2 = Triadafilopoulos | first2 = G. | title = Glycogenic acanthosis of the esophagus and gastroesophageal reflux. | journal = J Clin Gastroenterol | volume = 17 | issue = 1 | pages = 79-83 | month = Jul | year = 1993 | doi =  | PMID = 8409304 }}</ref>
*Benign.<ref name=pmid25632181>{{Cite journal  | last1 = Tsai | first1 = SJ. | last2 = Lin | first2 = CC. | last3 = Chang | first3 = CW. | last4 = Hung | first4 = CY. | last5 = Shieh | first5 = TY. | last6 = Wang | first6 = HY. | last7 = Shih | first7 = SC. | last8 = Chen | first8 = MJ. | title = Benign esophageal lesions: endoscopic and pathologic features. | journal = World J Gastroenterol | volume = 21 | issue = 4 | pages = 1091-8 | month = Jan | year = 2015 | doi = 10.3748/wjg.v21.i4.1091 | PMID = 25632181 }}</ref>
*Benign.<ref name=pmid25632181>{{Cite journal  | last1 = Tsai | first1 = SJ. | last2 = Lin | first2 = CC. | last3 = Chang | first3 = CW. | last4 = Hung | first4 = CY. | last5 = Shieh | first5 = TY. | last6 = Wang | first6 = HY. | last7 = Shih | first7 = SC. | last8 = Chen | first8 = MJ. | title = Benign esophageal lesions: endoscopic and pathologic features. | journal = World J Gastroenterol | volume = 21 | issue = 4 | pages = 1091-8 | month = Jan | year = 2015 | doi = 10.3748/wjg.v21.i4.1091 | PMID = 25632181 }}</ref>
*May be associated with [[GERD]];<ref name=pmid8409304/> however, lesions do not resolve with [[Proton pump inhibitor|PPI]] treatment.<ref name=pmid25632181/>
*May be associated with [[GERD]];<ref name=pmid8409304/><ref name=pmid22798107>{{Cite journal  | last1 = Nazligül | first1 = Y. | last2 = Aslan | first2 = M. | last3 = Esen | first3 = R. | last4 = Yeniova | first4 = AÖ. | last5 = Kefeli | first5 = A. | last6 = Küçükazman | first6 = M. | last7 = Dülger | first7 = AC. | last8 = Celik | first8 = Y. | title = Benign glycogenic acanthosis lesions of the esophagus. | journal = Turk J Gastroenterol | volume = 23 | issue = 3 | pages = 199-202 | month = Jun | year = 2012 | doi =  | PMID = 22798107 }}</ref> however, lesions do not resolve with [[Proton pump inhibitor|PPI]] treatment.<ref name=pmid25632181/>
*Possible association with ingestion of hot liquids.<ref name=pmid20524767/>
*Possible association with ingestion of hot liquids.<ref name=pmid20524767/>
*Described in the context of [[Cowden's disease]] when seen diffusely.<ref name=pmid9177527>{{Cite journal  | last1 = Kay | first1 = PS. | last2 = Soetikno | first2 = RM. | last3 = Mindelzun | first3 = R. | last4 = Young | first4 = HS. | title = Diffuse esophageal glycogenic acanthosis: an endoscopic marker of Cowden's disease. | journal = Am J Gastroenterol | volume = 92 | issue = 6 | pages = 1038-40 | month = Jun | year = 1997 | doi =  | PMID = 9177527 }}</ref>


==Gross/endoscopic==
==Gross/endoscopic==
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**Superficial clearing of the cytoplasm.
**Superficial clearing of the cytoplasm.
**Thickening.
**Thickening.
*No significant [[nuclear atypia]].


===Images===
===Images===
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====www====
====www====
*[http://scielo.isciii.es/pdf/diges/v102n5/carta3.pdf Glycogenic acanthosis (isciii.es)].
*[http://scielo.isciii.es/pdf/diges/v102n5/carta3.pdf Glycogenic acanthosis (isciii.es)].
==Stains==
Features:<ref name=pmid6981928>{{Cite journal  | last1 = Glick | first1 = SN. | last2 = Teplick | first2 = SK. | last3 = Goldstein | first3 = J. | last4 = Stead | first4 = JA. | last5 = Zitomer | first5 = N. | title = Glycogenic acanthosis of the esophagus. | journal = AJR Am J Roentgenol | volume = 139 | issue = 4 | pages = 683-8 | month = Oct | year = 1982 | doi = 10.2214/ajr.139.4.683 | PMID = 6981928 }}</ref>
*[[PAS stain|PAS]] +ve.
*[[PASD stain|PASD]] -ve.


==See also==
==See also==

Latest revision as of 10:44, 16 May 2015

Glycogenic acanthosis of the esophagus
Diagnosis in short

Glycogenic acanthosis of the esophagus. H&E stain.

LM squamous epithelium with (1) superficial clearing of the cytoplasm, and (2) thickening
Stains PAS +ve, PASD -ve
Site esophagus

Associated Dx possibly associated with gastroesophageal reflux disease
Syndromes possibly Cowden's disease when diffuse

Clinical history ingestion of hot liquids (???)
Prevalence uncommon
Endoscopy raised grey/white lesions
Prognosis benign

Glycogenic acanthosis of the esophagus, abbreviated GAE, is an uncommon benign change of the esophagus with a distinctive endoscopic appearance.

General

  • Uncommon - seen 3.5% of consecutive 2328 upper endoscopies.[1]
  • Benign.[2]
  • May be associated with GERD;[1][3] however, lesions do not resolve with PPI treatment.[2]
  • Possible association with ingestion of hot liquids.[4]
  • Described in the context of Cowden's disease when seen diffusely.[5]

Gross/endoscopic

  • Distinctive endoscopic appearance - grey/white raised lesion.[4]

Image

Microscopic

Features:[4]

  • Squamous epithelium with:
    • Superficial clearing of the cytoplasm.
    • Thickening.
  • No significant nuclear atypia.

Images

www

Stains

Features:[6]

See also

References

  1. 1.0 1.1 Vadva, MD.; Triadafilopoulos, G. (Jul 1993). "Glycogenic acanthosis of the esophagus and gastroesophageal reflux.". J Clin Gastroenterol 17 (1): 79-83. PMID 8409304.
  2. 2.0 2.1 2.2 Tsai, SJ.; Lin, CC.; Chang, CW.; Hung, CY.; Shieh, TY.; Wang, HY.; Shih, SC.; Chen, MJ. (Jan 2015). "Benign esophageal lesions: endoscopic and pathologic features.". World J Gastroenterol 21 (4): 1091-8. doi:10.3748/wjg.v21.i4.1091. PMID 25632181.
  3. Nazligül, Y.; Aslan, M.; Esen, R.; Yeniova, AÖ.; Kefeli, A.; Küçükazman, M.; Dülger, AC.; Celik, Y. (Jun 2012). "Benign glycogenic acanthosis lesions of the esophagus.". Turk J Gastroenterol 23 (3): 199-202. PMID 22798107.
  4. 4.0 4.1 4.2 Lopes, S.; Figueiredo, P.; Amaro, P.; Freire, P.; Alves, S.; Cipriano, MA.; Gouveia, H.; Sofia, C. et al. (May 2010). "Glycogenic acanthosis of the esophagus: an unusually endoscopic appearance.". Rev Esp Enferm Dig 102 (5): 341-2. PMID 20524767.
  5. Kay, PS.; Soetikno, RM.; Mindelzun, R.; Young, HS. (Jun 1997). "Diffuse esophageal glycogenic acanthosis: an endoscopic marker of Cowden's disease.". Am J Gastroenterol 92 (6): 1038-40. PMID 9177527.
  6. Glick, SN.; Teplick, SK.; Goldstein, J.; Stead, JA.; Zitomer, N. (Oct 1982). "Glycogenic acanthosis of the esophagus.". AJR Am J Roentgenol 139 (4): 683-8. doi:10.2214/ajr.139.4.683. PMID 6981928.