Talk:Esophagus

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See also: Talk:Celiac sprue.

Normal 1

Microscopic

A. The sections shows normal small bowel mucosa with Brunner's glands.
B. The sections show normal antral-type gastric mucsoa.
C. The sections show normal body-type gastric mucosa.
D. The sections show normal esophageal-type mucosa.

Final diagnosis

A-D. Duodenum, gastric antrum, gastric body, esophagus; biopsies (x4) - no pathology.

Normal 2

Microscopic

A. The sections shows normal small bowel mucosa with Brunner's glands.
B. The sections show normal antral-type gastric mucsoa.
C. The sections show normal body-type gastric mucosa.
D. The sections show normal esophageal-type mucosa.

Final diagnosis

A. Duodenum, biopsy - no pathologic diagnosis.
B. Gastric antrum, biopsy - no pathologic diagnosis.
C. Gastric body, biopsy - no pathologic diagnosis.
D. Esophagus, biopsy - no pathologic diagnosis.

Normal 3

Microscopic

A. The sections shows normal small bowel mucosa without Brunner's glands.
B. The sections shows normal small bowel mucosa without Brunner's glands. Several morphologically benign lymphoid nodules are present. The mucosa is flatted overlying the lymphoid tissue. Normal villi are present.
C. The sections show normal antral-type gastric mucsoa.
D. The sections show normal body-type gastric mucosa.
E. The sections show normal esophageal-type mucosa.

Final diagnosis

A. Duodenum, biopsy - no pathology.
B. Duodenum, cap, biopsy - lymphoid nodules; no pathology.
C. Stomach, antrum, biopsy - body-type gastric mucosa; no pathology.
D. Stomach, body, biopsy - body-type gastric mucosa; no pathology.
E. Esophagus, distal, biopsy - no pathology.

IBD?

Microscopic

A. The sections show small bowel mucosa and Brunner's glands with focal neutrophilic infiltration of the epithelium. No granulomas are identified.
B. The sections show antral-type gastric mucosa with a mild, and focally moderate, inflammatory infiltrate consisting of neutrophils, plasma cells and lymphocytes. No granulomas are identified.
C. The sections show body-type gastric mucosa with a mild inflammatory infiltrate consisting of neutrophils, plasma cells and lymphocytes. No granulomas are identified.
D. The sections show non-keratinized stratified squamous epithelium without significant inflammation and normal maturation to the free surface. There is edema and a mild neutrophilic and lymphoplasmacytic infiltration of the lamina propria, which is more prominent adjacent to the basal layer of the epithelium. No granulomas are identified.

Final diagnosis

A. Duodenum, biopsy - Mild focal acute inflammation, see comment.
B. Stomach, antrum, biopsy - Mild chronic active inflammation with focal moderate chronic active inflammation, see comment.
C. Stomach, body, biopsy - Mild chronic active inflammation, see comment.
D. Esophagus, distal, biopsy - Focal chronic subepithelial inflammation, see comment.

Comment

The histomorphologic findings are compatible with inflammatory bowel disease. There are no histomorphologic findings to suggest an infective etiology; however, this cannot be definitively excluded.

Eosinophilic esophagitis

Microscopic description

A. The sections show small bowel with Brunner's glands and a mild focal neutrophilic infiltrate. The villous architecture is largely preserved.
B. The sections show small bowel with Brunner's glands and moderate chronic active neutrophilic inflammation with focal ulceration and necrotic debris. There is villous blunting. There are no significant number of intraepithelial lymphocytes.
C. The sections show antral-type gastric mucosa with infiltration moderate eosinophilia, neutrophils and clusters of plasma cells. Focally, the eosinophils are intraepithelial.
D. The sections show body-type gastric mucosa with clusters of eosinophilis, neutrophils and plasma cells.
E-G. The sections show esophageal mucosa with a prominent eosinophilic infiltrate and focal clustering of eosinophilis. The epithelial papillae are elongated, there is basal cell hyperplasia and the epithelium is edematous. There are more than 20 eosinophilis / 0.216 mm^2 in all sites. The area 0.216 mm^2 is one high power field (HPF) using the 40x objective.

Final diagnosis

A. Duodenum, biopsy - Mild focal duodenitis, see comment.
B. Duodenum, cap, biopsy - Moderate focal chronic active duodenitis with mild eosinophilia and ulceration, see comment.
C. Stomach, antrum, biopsy - Moderate chronic active gastritis with mild eosinophilia.
D. Stomach, body, biopsy - Mild chronic active gastritis with mild eosinophilia.
E. Esophagus, distal, biopsy - Eosinophilic esophagitis.
F. Esophagus, middle, biopsy - Eosinophilic esophagitis.
G. Esophagus, upper, biopsy - Eosinophilic esophagitis.

Comment

The histomorphologic findings in this biopsy are not suggestive of celiac disease.


Esophagitis

Microsopic

A, B. The sections shows normal small bowel mucosa with Brunner's glands.
C, D. The sections show body-type gastric mucsoa with a mild, and focally moderate, inflammatory infiltrate consisting of neutrophils, plasma cells and lymphocytes. No granulomas are identified. No helicobacter-type organisms are identified with routine stains.
E, F. The sections show esophageal-type mucosa with rare eosinophils and lymphocytes. The papilla lengths are normal. There is no basal cell hyperplasia. No viral cytopathic changes are seen. No organisms are seen with routine stains.

Final diagnosis

A. Duodenum, biopsy - no pathologic diagnosis.
B. Duodenum, cap, biopsy - no pathologic diagnosis.
C. Stomach ("antrum"), biopsy - body-type gastric mucosa with mild, active inflammation.
D. Stomach, body, biopsy - body-type gastric mucosa with mild, active inflammation.
E. Esophagus, distal, biopsy - mild esophagitis.
F. Esophagus, mid, biopsy - mild esophagitis.