Glycogenic acanthosis of the esophagus

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

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

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.

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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.
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