Multiple squamous hyperplastic-fibrous inflammatory polyps of the oesophagus: a new feature of eosinophilic oesophagitis?

Mulder, Daniel J.; Gander, Sarah; Hurlbut, David; Soboleski, Don; Smith, R G; Justinich, Christopher J.

doi:10.1136/jcp.2009.066100

Cited by 15 publications

(12 citation statements)

References 10 publications

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“…Reflux esophagitis is only one cause of esophagitis, and there are other postulated triggers of esophageal polyps. Despite recent case reports, none of our patients had endoscopic‐histologic evidence of eosinophilic esophagitis, and esophagitis did not consistently relate to any particular histologic subtype.…”

Section: Discussioncontrasting

confidence: 88%

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Esophageal polyps in pediatric patients undergoing routine diagnostic upper gastrointestinal endoscopy: a multicenter study

Septer

Cuffari²,

Attard

2013

Dis Esophagus

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Esophageal polyps are uncommon findings in pediatric patients, and reports have been limited to case reports. Esophageal polyps have been previously ascribed to esophagitis secondary to gastroesophageal reflux, medications, infections and recurrent vomiting. They have been associated with underlying conditions such as hiatal hernia, Barrett's esophagus, eosinophilic esophagitis and Crohn's disease. Presenting complaints of children with esophageal polyps have included vomiting, dysphagia, hematemesis and abdominal pain. The aim of this paper is to characterize the incidence, clinical presentation and progression, histologic subtypes and associated mucosal abnormalities in children with esophageal polyps. A retrospective multicenter study was performed at four institutions identifying diagnosis of esophageal polyps in pediatric patients (<21 years). Information was obtained from patient charts, endoscopy reports and histopathology reports. Specimens and slides were examined by experienced pediatric pathologists for all included cases. Esophageal polyps were identified in 13 patients (9 M) from 9438 esophagogastroduodenoscopies (0.14%). Mean age of subjects was 9.2 years. Vomiting was the most common indication for endoscopy. Polyp location was at the gastroesophageal junction in 7 of the 13 cases. Most polyps were inflammatory (n = 7). Esophagitis was noted in 69% of those with esophageal polyps. Repeat endoscopies in six patients at a mean interval of 8 months noted persistence of polyps in all six patients. This paper is the first to characterize esophageal polyps in pediatrics. These polyps are rare in children and often are associated with esophagitis. Presenting complaints seem to vary by age. Polyps did not consistently change with either time or acid suppression. The optimal management strategy has yet to be defined and likely depends on the underlying pathophysiologic process.

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Section: Discussioncontrasting

confidence: 88%

“…Resolution of polyps has also been reported with antireflux therapy. 24 Medications, infections and recurrent vomiting 1 are other potential etiologies, while underlying neurofibromatosis, 9,13 Crohn's disease, 25,26 eosinophilic esophagitis 27,28 and Barrett's esophagus 1,29 have also been reported in adults.…”

Section: Introductionmentioning

confidence: 99%

Esophageal polyps in pediatric patients undergoing routine diagnostic upper gastrointestinal endoscopy: a multicenter study

Septer

Cuffari²,

Attard

2013

Dis Esophagus

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“…EREFS has been validated in studies performed in Western countries, and shown to have usefulness for diagnosis as well as monitoring treatment response in patients with EoE 19 22 23 . In addition, several minor endoscopic findings have been reported, such as esophageal polyps 24 25 26 and cobblestone-like appearance 27 . ABS also features nodular formation, though the linear arrangement occurs at uniform intervals and is completely different from those previously reported findings.…”

Section: Discussionmentioning

confidence: 99%

Ankylosaurus back sign: novel endoscopic finding in esophageal eosinophilia patients indicating proton pump inhibitor response

et al. 2018

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Background and study aims Characteristic endoscopic findings, such as linear furrows, rings, and whitish exudates, indicate the presence of esophageal eosinophilia (EE), though no specific findings are known to distinguish eosinophilic esophagitis (EoE) from proton pump inhibitor-responsive esophageal eosinophilia (PPI-REE). Here, we present a novel endoscopic finding in some EE patients possessing a linear longitudinal arrangement of whitish nodules with the appearance of the back of an Ankylosaurus dinosaur, termed Ankylosaurus back sign (ABS), and evaluations of its significance in affected patients. Patients and methods Fifty-five patients diagnosed with EE (≥ 15 eosinophils/high power field) who were treated at our hospital and shown to evaluate a PPI response were enrolled. Endoscopic findings at baseline and clinical parameters were retrospectively reviewed. Furthermore, the clinicopathological features of patients with ABS, as well as the relationship between its presence and PPI response were evaluated. Results Fifty-five patients (47 males, 8 females) with EE (17 with EoE, 38 with PPI-REE) were evaluated, of whom 50 (90.9 %) had linear furrows, the most frequently found feature, while ABS was found in 9 (16.4 %). Inter-observer agreement was substantial for ABS (κ 0.77). Interestingly, all patients with ABS had PPI-REE. Our findings revealed that the presence of ABS was closely associated with reflux esophagitis (RE) in patients with PPI-REE. Conclusions Although ABS was less frequent than typical endoscopic findings such as linear furrows in EE, this novel finding was closely associated with PPI-REE accompanied with RE. The clinical implications of ABS in patients with EE should be investigated further.

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“…They are most common around the gastro-oesophageal junction and distal oesophagus and are associated with gastro-oesophageal reflux disease in most cases. They may also be seen with injury due to medication, infection, anastomotic or polypectomy sites, vomiting, photodynamic therapy and eosinophilic oesophagitis [1][2][3][4].…”

Section: Inflammatory/hyperplastic Polypmentioning

confidence: 99%

Polyps and Tumour‐Like Lesions of the Oesophagus

Parfitt

Driman

2012

Morson and Dawson's Gastrointestinal Pathology

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Multiple squamous hyperplastic-fibrous inflammatory polyps of the oesophagus: a new feature of eosinophilic oesophagitis?

Cited by 15 publications

References 10 publications

Esophageal polyps in pediatric patients undergoing routine diagnostic upper gastrointestinal endoscopy: a multicenter study

Esophageal polyps in pediatric patients undergoing routine diagnostic upper gastrointestinal endoscopy: a multicenter study

Ankylosaurus back sign: novel endoscopic finding in esophageal eosinophilia patients indicating proton pump inhibitor response

Polyps and Tumour‐Like Lesions of the Oesophagus

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