GASTROENTEROLOGY ARTICLE OF THE WEEK
April 16, 2009
Odze RD. Pathology of eosinophilic esophagitis: What the clinician needs to know. Am J Gastroenterol 2009;104:485-490
1. Pathologic features of severe GERD include
a. > 40 eosinophils per HPF
b. surface ulceration
c. ballooning degeneration
d. cell necrosis
e. basal cell hyperplasia affecting <20% of the epithelium
f. eosinophilic microabscesses
True or False
2. The normal esophagus contains no eosinophils
3. Neutrophilic infiltration of the squamous epithelium associated with surface ulceration is typically seen together with eosinophila in eosinophilic esophagitis
4. Eosinophilic infiltration of the esophagus in EE is often patchy, requiring multiple biopsies to confirm the diagnosis
5. Proximal and distal esophageal biopsies are important to asses the “gradient” of eosinophilia throughout the esophagus
6. Pathologically, eosinophilic esophagitis can be easily differentiated from eosinophilic gastroenteritis when looking at esophageal biopsies