Difference between revisions of "Esophageal stricture"

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'''Esophageal stricture''' is a [[clinical diagnosis]]. Considered broadly, strictures may be benign or [[malignant]].
'''Esophageal stricture''' is usually a [[clinical diagnosis]]. Considered broadly, strictures may be benign or [[malignant]].


This article deals primarily with '''benign stricture of the [[esophagus]]''' or '''benign esophageal stricture'''.
This article deals primarily with '''benign stricture of the [[esophagus]]''' or '''benign esophageal stricture'''.


==General==
==General==
Strictures in general:
*Malignant - it is the pathologist's job to help rule-out these.
*Benign.
*Most are distal.<ref name=pmid6512226>{{Cite journal  | last1 = Kozarek | first1 = RA. | title = Proximal strictures of the esophagus. | journal = J Clin Gastroenterol | volume = 6 | issue = 6 | pages = 505-11 | month = Dec | year = 1984 | doi =  | PMID = 6512226 }}</ref>
Treatment:
Treatment:
*Stenting.<ref name=pmid24117639>{{Cite journal  | last1 = Hourneaux de Moura | first1 = EG. | last2 = Toma | first2 = K. | last3 = Goh | first3 = KL. | last4 = Romero | first4 = R. | last5 = Dua | first5 = KS. | last6 = Felix | first6 = VN. | last7 = Levine | first7 = MS. | last8 = Kochhar | first8 = R. | last9 = Appasani | first9 = S. | title = Stents for benign and malignant esophageal strictures. | journal = Ann N Y Acad Sci | volume = 1300 | issue =  | pages = 119-43 | month = Oct | year = 2013 | doi = 10.1111/nyas.12242 | PMID = 24117639 }}</ref>
*Stenting.<ref name=pmid24117639>{{Cite journal  | last1 = Hourneaux de Moura | first1 = EG. | last2 = Toma | first2 = K. | last3 = Goh | first3 = KL. | last4 = Romero | first4 = R. | last5 = Dua | first5 = KS. | last6 = Felix | first6 = VN. | last7 = Levine | first7 = MS. | last8 = Kochhar | first8 = R. | last9 = Appasani | first9 = S. | title = Stents for benign and malignant esophageal strictures. | journal = Ann N Y Acad Sci | volume = 1300 | issue =  | pages = 119-43 | month = Oct | year = 2013 | doi = 10.1111/nyas.12242 | PMID = 24117639 }}</ref>
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==Microscopic==
==Microscopic==
Features:
Features:
*Squamous mucosa:
*Squamous mucosa with irritation:
**+/-Keratinization.
**+/-Keratinization.
**Intraepithelial lymphocytes.
**Intraepithelial lymphocytes.
**Basal cell hyperplasia.
**Basal cell hyperplasia.
*Fibrosis (deep) - usually not seen.


DDx:
DDx:
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==See also==
==See also==
*[[Esophagus]].
*[[Esophagus]].
*[[Achalasia]].


==References==
==References==

Latest revision as of 02:59, 22 February 2014

Esophageal stricture is usually a clinical diagnosis. Considered broadly, strictures may be benign or malignant.

This article deals primarily with benign stricture of the esophagus or benign esophageal stricture.

General

Strictures in general:

  • Malignant - it is the pathologist's job to help rule-out these.
  • Benign.
  • Most are distal.[1]

Treatment:

  • Stenting.[2]
  • Endoscopic dilation.[3]
  • Surgery.

Microscopic

Features:

  • Squamous mucosa with irritation:
    • +/-Keratinization.
    • Intraepithelial lymphocytes.
    • Basal cell hyperplasia.
  • Fibrosis (deep) - usually not seen.

DDx:

Sign out

ESOPHAGUS, BIOPSY:
- SQUAMOUS MUCOSA WITH BASAL CELL HYPERPLASIA, MILD INTRAEPITHELIAL EDEMA, FOCAL EARLY
  KERATINIZATION AND INTRAEPITHELIAL LYMPHOCYTES.
- SCANT COLUMNAR EPITHELIUM WITH MODERATE CHRONIC INACTIVE INFLAMMATION.
- NEGATIVE FOR INTESTINAL METAPLASIA.
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.

See also

References

  1. Kozarek, RA. (Dec 1984). "Proximal strictures of the esophagus.". J Clin Gastroenterol 6 (6): 505-11. PMID 6512226.
  2. Hourneaux de Moura, EG.; Toma, K.; Goh, KL.; Romero, R.; Dua, KS.; Felix, VN.; Levine, MS.; Kochhar, R. et al. (Oct 2013). "Stents for benign and malignant esophageal strictures.". Ann N Y Acad Sci 1300: 119-43. doi:10.1111/nyas.12242. PMID 24117639.
  3. Singhal, S.; Hasan, SS.; Cohen, DC.; Pfanner, T.; Reznik, S.; Duddempudi, S. (Sep 2013). "Multi-disciplinary approach for management of refractory benign occlusive esophageal strictures.". Therap Adv Gastroenterol 6 (5): 365-70. doi:10.1177/1756283X13492000. PMID 24003337.