S Mueller1, D Neureiter, T Aigner, M Stolte. 1. Institute of Pathology, University of Munich, Munich, Germany. susanna.mueller@med.uni-muenchen.de
Abstract
AIMS: Eosinophil infiltration of the oesophageal epithelium is the cardinal pathomorphological finding in eosinophilic oesophagitis (EO), but gastro-oesophageal reflux disease (GORD) is also associated with increased eosinophils. The aim was to compare histological parameters for the diagnosis of EO versus GORD on routinely taken biopsy specimens. METHODS AND RESULTS: One hundred and five routine biopsy specimens with EO (n = 62), GORD (n = 24) and probable EO (n = 19) from 74 patients (52 men, 22 women; mean age 43.7 years) were analysed for numbers of eosinophils, mast cells, degranulation and qualitative changes of oesophageal epithelium using immunohistochemistry with monoclonal antibodies against eosinophil peroxidase and eosinophil major basic protein and mast cell tryptase. Eosinophil infiltration was significantly higher in EO than in GORD both on haematoxylin and eosin staining (54.8 versus 9.1; P < 0.05) and immunohistochemistry (77.5 versus 24.7; P < 0.05). Eosinophil degranulation was significantly more intense in EO than in GORD (1.16 versus 0.41; P < 0.05). Furthermore, eosinophilia-codependent secondary qualitative changes of squamous epithelium in EO were generally more extensive than those in GORD. CONCLUSIONS: Histological differential diagnosis of EO and GORD should be based on eosinophil counts, secondary morphological changes of eosinophils and oesophageal squamous epithelium, especially in cases suspicious of EO.
AIMS: Eosinophil infiltration of the oesophageal epithelium is the cardinal pathomorphological finding in eosinophilic oesophagitis (EO), but gastro-oesophageal reflux disease (GORD) is also associated with increased eosinophils. The aim was to compare histological parameters for the diagnosis of EO versus GORD on routinely taken biopsy specimens. METHODS AND RESULTS: One hundred and five routine biopsy specimens with EO (n = 62), GORD (n = 24) and probable EO (n = 19) from 74 patients (52 men, 22 women; mean age 43.7 years) were analysed for numbers of eosinophils, mast cells, degranulation and qualitative changes of oesophageal epithelium using immunohistochemistry with monoclonal antibodies against eosinophil peroxidase and eosinophil major basic protein and mast cell tryptase. Eosinophil infiltration was significantly higher in EO than in GORD both on haematoxylin and eosin staining (54.8 versus 9.1; P < 0.05) and immunohistochemistry (77.5 versus 24.7; P < 0.05). Eosinophil degranulation was significantly more intense in EO than in GORD (1.16 versus 0.41; P < 0.05). Furthermore, eosinophilia-codependent secondary qualitative changes of squamous epithelium in EO were generally more extensive than those in GORD. CONCLUSIONS: Histological differential diagnosis of EO and GORD should be based on eosinophil counts, secondary morphological changes of eosinophils and oesophageal squamous epithelium, especially in cases suspicious of EO.
Authors: Evan S Dellon; Xiaoxin Chen; C Ryan Miller; John T Woosley; Nicholas J Shaheen Journal: Am J Gastroenterol Date: 2012-07-10 Impact factor: 10.864
Authors: Su Hwan Kim; Ji Bong Jeong; Ji Won Kim; Seong-Joon Koh; Byeong Gwan Kim; Kook Lae Lee; Mee Soo Chang; Jong Pil Im; Hyoun Woo Kang; Cheol Min Shin Journal: World J Gastroenterol Date: 2014-08-21 Impact factor: 5.742
Authors: Evan S Dellon; Xiaoxin Chen; C Ryan Miller; Karen J Fritchie; Tara C Rubinas; John T Woosley; Nicholas J Shaheen Journal: Am J Gastroenterol Date: 2010-10-26 Impact factor: 10.864
Authors: Biljana Jovov; Jianwen Que; Nelia A Tobey; Zorka Djukic; Brigid L M Hogan; Roy C Orlando Journal: Am J Gastroenterol Date: 2011-03-29 Impact factor: 10.864
Authors: Chang Zeng; Simone Vanoni; David Wu; Julie M Caldwell; Justin C Wheeler; Kavisha Arora; Taeko K Noah; Lisa Waggoner; John A Besse; Amnah N Yamani; Jazib Uddin; Mark Rochman; Ting Wen; Mirna Chehade; Margaret H Collins; Vincent A Mukkada; Philip E Putnam; Anjaparavanda P Naren; Marc E Rothenberg; Simon P Hogan Journal: J Allergy Clin Immunol Date: 2018-05-04 Impact factor: 10.793