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 = | ||
| Line 16: | Line 16: | ||
| 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 = | ||
| Line 30: | Line 30: | ||
| 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== | ||
| Line 50: | Line 51: | ||
**Superficial clearing of the cytoplasm. | **Superficial clearing of the cytoplasm. | ||
**Thickening. | **Thickening. | ||
*No significant [[nuclear atypia]]. | |||
===Images=== | ===Images=== | ||
| Line 63: | Line 65: | ||
====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
GAE - low mag.
GAE - intermed. mag.
GAE - intermed. mag.
GAE - high mag.
GAE - intermed. mag.
GAE - high mag.
www
Stains
Features:[6]
See also
References
- ↑ 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.
- ↑ 2.0 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.
- ↑ 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.
- ↑ 4.0 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.
- ↑ 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.
- ↑ 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.