Esophageal stricture

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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.